PROMISING METHODS FOR DIAGNOSING VARICOSE VEINS DURING PREGNANCY
Keywords:
venous insufficiency, thrombosis, fetoplacental circulation, ultrasound duplex scanning, compression therapy, pregnancyAbstract
The aim of the study was to identify key diagnostic measures to reduce the risk of complications of varicose veins in pregnant women, such as thrombosis and inflammatory processes in the veins. The study involved 100 women who were observed at the Samarkand branch of the Republican Scientific and Practical Center for Maternal and Child Health and the maternity hospital of the multidisciplinary clinic of the Samarkand State Medical University. Diagnostic methods included ultrasound duplex scanning of the veins of the lower extremities, pelvic veins, fetal Doppler and laboratory tests (D- dimer, fibrinogen, C-reactive protein, thrombodynamics) to assess the risk of thrombosis and inflammation. Elevated levels of D-dimer and 75% fibrinogen were detected in 70% of women, indicating a high risk of thrombosis, especially in the third trimester. Ultrasound scanning revealed 65% of women with venous valve disorders, and 20% with signs of thrombosis. 40% of patients had elevated C-reactive protein levels, indicating inflammatory processes. Women who use compression garments from the first trimester are less likely to experience complications such as swelling, pain, and heaviness in the legs. The data obtained highlight the importance of early diagnosis, monitoring of blood clotting parameters, and inflammatory markers.
References
Patnaik, N., Pradhan, N.R. (2021). Chronic venous insufficiency in pregnant women. Indian Journal of Vascular and Endovascular Surgery, 8(3), 213-215.
https://doi.org/10.4103/ijves.ijves_71_20.
Maralbaeva, A.A., Saidahmetova, Ch.T. (2020). Comparative characteristics of biometric indicators of the prenatal condition of the organ of vision in pregnant women with various types of clinical refraction. Bulletin of the Kyrgyz-Russian Slavic University, 20(9), 115-120.
https://arch.kyrlibnet.kg/uploads/KRSUMARALBAEVAA.A.2020-9.pdf
Kamat, D., Kavlekar, N. (2020). A rare association of puerperal ovarian venous thrombosis with pseudomembranous colitis. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 9(10), 4307-4310. https://doi.org/10.18203/2320-1770.ijrcog20204331
Desjardins, B., Hanley, M., Steigner, M.L., Aghayev, A., Azene, E.M., Bennett, S.J., Chandra, A., Hedgire, S.S., Lo, B.M., Mauro, D.M., Ptak, T., Singh-Bhinder, N., Suranyi, P.S., Verma, N., Dill, K.E. (2020). ACR Appropriateness Criteria® suspected upper extremity deep vein thrombosis. Journal of the American College of Radiology, 17(5), 315-322.
https://doi.org/10.1016/j.jacr.2020.01.020
Singh, B., Kour, M., Pradhan, S. (2020). Preoperative assessment of primary varicose veins of lower limbs by duplex color doppler ultrasound: A validation study. Global Journal for Research Analysis, 9(10), 30-32. https://doi.org/10.36106/gjra/7807974.
O'Brien, J., Dingle, M. (2022). A dual realist review: Compression for leg swelling at the end of life has potential quality of life benefit. Journal of Advanced Nursing, 78(12), 4003-4018. https://doi.org/10.1111/jan.15458
Guedes, P.M., Saldanha, N.A., Matos, P.M., Carvalho, F.S., Veiga, G., Norton, P. (2020). Occupational leg edema-use of compression stockings. Porto Biomedical Journal, 5(6), e093. https://doi.org/10.1097/j.pbj.0000000000000093
Tiwari, A., Walsh, S.R., Davies, A.H., Tang, T.Y. (2020). A need for evidence to guide treatment recommendation for women with chronic venous disease during childbearing years. Phlebology, 35(8), 548-549. https://doi.org/10.1177/0268355520916395
Güner, A., Kalçık, M., Gürsoy, M.O., Gündüz, S., Astarcıoğlu, M.A., Bayam, E., Kalkan, S., Yesin, M., Karakoyun, S., Özkan, M. (2020). Comparison of different anticoagulation regimens regarding maternal and fetal outcomes in pregnant patients with mechanical prosthetic heart valves (from the Multicenter ANATOLIA-PREG Registry). American Journal of Cardiology, 127, 113- 119https://doi.org/10.1016/j.amjcard.2020.04.010
Muratova, N.J., Shokirova, N.G. (2022). Treatment of placental insufficiency in pregnant women with antiphospholipid syndrome and varicose veins. Oriental Journal of Medicine and Pharmacology, 2(02), 46-54. https://doi.org/10.37547/supsci-ojmp-02-02-06
Asúnsolo, Á., Chaowen, C., Ortega, M.A., Coca, S., Borrell, L.N., De León-Luis, J., García- Honduvilla, N., Álvarez-Mon, M., Buján, J. (2021). Association between lower extremity venous insufficiency and intrapartum fetal compromise: A nationwide cross-sectional study. Frontiers in Medicine (Lausanne), 8, 577096. https://doi.org/10.3389/fmed.2021.577096
Pieters, M. (2021). Small molecules: A novel approach to alter fibrinogen production and impact venous thrombosis. Thrombosis and Haemostasis, 121(4), 408. https://doi.org/10.1055/s- 0040-1721318
Verma, R., Chaturvedi, M., Sabu, S., Pal, K. (2020). Evaluation of fibrinogen level as a non conventional risk factor in patients of acute MI in north Indian patients. Journal of Medical Science and Clinical Research, 8(3), 618-622. https://doi.org/10.18535/jmscr/v8i3.107
Knight Nee Shingler, S.L., Robertson, L., Stewart, M. (2021). Graduated compression stockings for the initial treatment of varicose veins in people without venous ulceration. Cochrane Database of Systematic Reviews, 7(7), CD008819. https://doi.org/10.1002/14651858.CD008819.pub4.
Kakkos, S.K., Gohel, M., Baekgaard, N., Bauersachs, R., Bellmunt-Montoya, S., Black, S.A., Ten Cate-Hoek, A.J., Elalamy, I., Enzmann, F.K., Geroulakos, G., Gottsäter, A., Hunt, B.J., Mansilha, A., Nicolaides, A.N., Sandset, P.M., Stansby, G., Esvs Guidelines Committee, de Borst, G.J., Bastos Gonçalves, F., Chakfé, N., Hinchliffe, R., Kolh, P., Koncar, I., Lindholt, J.S., Tulamo, R., Twine, C.P., Vermassen, F., Wanhainen, A., Document Reviewers, De Maeseneer, M.G., Comerota, A.J., Gloviczki, P., Kruip, M.J.H.A., Monreal, M., Prandoni, P., Vega de Ceniga, M. (2021). European Society for Vascular Surgery 2021 Clinical practice guidelines on the management of chronic venous disease. European Journal of Vascular and Endovascular Surgery, 61(1), 9-82. https://doi.org/10.1016/j.ejvs.2020.09.023
Babadjanov, Sh.D., Rasulyev, B.Kh., Abduraimov, T.Ph. (2019). Collection of clinical protocols on obstetrics. Tashkent: Baktria Press.
Shomurodovich Y. O., Rakhimovna K. D. THE EFFECT OF DIOSMIN IN VARICOSE VEINS IN PREGNANT //EDITOR COORDINATOR. – 2021. – С. 283.
Kakkos, S.K., Gohel, M., Baekgaard, N., Bauersachs, R., Bellmunt-Montoya, S., Black, S.A., ten Cate-Hoek, A.J., Elalamy, I., Enzmann, F.K., Geroulakos, G., Gottsäter, A., Hunt, B.J., Mansilha, A., Nicolaides, A.N., Sandset, P.M., Stansby, G. (2020). European society for vascular surgery (ESVS) 2021 clinical practice guidelines on the management of venous thrombosis. European Journal of Vascular and Endovascular Surgery. https://doi.org/10.1016/j.ejvs.2020.09.023
Gloviczki, P., Lawrence, P.F., Wasan, S.M., Meissner, M.H., Almeida, J., Brown, K.R., Bush, R.L., Di Iorio, M., Fish, J., Fukaya, E., Gloviczki, M.L., Hingorani, A., Jayaraj, A., Kolluri, R., Murad, M.H., Obi, A.T., Ozsvath, K.J., Singh, M.J., Vayuvegula, S., Welch, H.J. (2024). The 2022 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society clinical practice guidelines for the management of varicose veins of the lower extremities. Part I. Duplex Scanning and Treatment of Superficial Truncal Reflux. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 11(2), 231-261. https://www.jvsvenous.org/article/S2213- 333X(22)00417-6/fulltext
World Medical Association. (2013). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA, 310(20), 2191-2194. https://jamanetwork.com/journals/jama/fullarticle/1760318
Zhao, X., Tao, H.P., Wang, C., Hu, F.R., Pan, Q.Y. (2021). Changes of anti-β2 glycoprotein I antibody IgA/G/M, platelet aggregation rate, plasma fibrinogen and d-dimer in guiding venous thrombosis during pregnancy. European Review for Medical and Pharmacological Sciences, 25(2), 591-597. https://doi.org/10.26355/eurrev_202101_24616
Franchini, M., Focosi, D., Pezzo, M., Mannucci, P. (2023). How we manage a high D-dimer. Haematologica, 109(4), 1035-1045. https://doi.org/10.3324/haematol.2023.283966
Dong, L., Han, W., Xiong, G., Zhang, Y., Yang, C. (2021). Prediction value of plasma D- dimer level changes on venous thromboembolism during pregnancy. Journal of Maternal-Fetal & Neonatal Medicine, 35(25), 7486 - 7490. https://doi.org/10.1080/14767058.2021.1949706
Morikawa, M., Matsunaga, S., Makino, S., Takeda, Y., Hyoudo, H., Nii, M., Serizawa, M., Itakura, A., Adachi, T., Kobayashi, T. (2021). Effect of hypofibrinogenemia on obstetrical disseminated intravascular coagulation in Japan in 2018: A multicenter retrospective cohort study. International Journal of Hematology, 114(1), 18-34. https://doi.org/10.1007/s12185-021-03119-5
Velik-Salchner, C., Haas, T., Innerhofer, P., Streif, W., Nussbaumer, W., Klingler, A., Klima, G., Martinowitz, U., Fries, D. (2007). The effect of fibrinogen concentrate on thrombocytopenia. Journal of Thrombosis and Haemostasis, 5(5), 1019-1025. https://doi.org/10.1111/j.1538- 7836.2007.02481.x
Saliba-Júnior, O.A., Rollo, H.A., Saliba, O., Sobreira, M.L. (2022). Positive perception and efficacy of compression stockings for prevention of lower limb edema in pregnant women. Jornal Vascular Brasileiro, 21, e20210101. https://doi.org/10.1590/1677-5449.210101
Ochalek, K. (2021). Three-year follow-up of the compression use in lower limb edema during pregnancy: A case report. Journal of Vascular Nursing, 39(2), 43-46. https://doi.org/10.1016/j.jvn.2021.04.002
Casadaban, L.C., Moriarty, J.M., Hoffman, C.H. (2021). Physical examination and ultrasound evaluation of patients with superficial venous disease. Seminars in Interventional Radiology, 38(2), 167-175. https://doi.org/10.1055/s-0041-1727103
Mousa, A.Y., Labropoulos, N. (2021). Color Duplex for Diagnosis of Venous Reflux. In: AbuRahma, A.F., Perler, B.A. (eds) Noninvasive Vascular Diagnosis. Springer, Cham. https://doi.org/10.1007/978-3-030-49616-6_41-1
Filip, S.S., Rusyn, V.V., Hadzheha, І.І. (2021). Venous hemodynamics in acute varicothrombophlebitis in the great saphenous vein basin. Art of Medicine, 69-74. https://doi.org/10.21802/ARTM.2021.1.17.69
Yevgi, R., Bilge, N., Şimşek, F., Eren, A., Cimilli Senocak, G.N. (2022). Vitamin D levels and C-reactive protein/albumin ratio in pregnant women with cerebral venous sinus thrombosis. Journal of Thrombosis and Thrombolysis, 53(2), 532-539 https://doi.org/10.1007/s11239-021- 02541-0
Guan, X., Fu, Y., Liu, Y., Cui, M., Zhang, C., Zhang, Q., Li, C., Zhao, J., Wang, C., Song, J., Dong, J. (2023). The role of inflammatory biomarkers in the development and progression of pre- eclampsia: A systematic review and meta-analysis. Frontiers in Immunology, 14, 1156039. https://doi.org/10.3389/fimmu.2023.1156039
Rizaev Jasur Alimjanovich , Agababyan Larisa Rubenovna , Davlatova Aziza, Ahmedova Aziza Tayirovna , Rasulova Feruza Golibovna , The state of the oral cavity in pre-pregnant women, Journal of reproductive health and uronephrology research 2023, vol. 4, issue 4, pp7-11
Rizaev J. A., Nazarova N. S., Vohidov E. R. HOMILADOR AYOLLARDA PARODONT KASALLIKLARI RIVOJLANISHINING PATOGENETIK JIHATLARI //Журнал гуманитарных
и естественных наук. – 2024. – №. 11 [2]. – С. 104-107.
Shakhanova S. et al. MELANOMA OF THE SKIN AND PREGNANCY //Eurasian Journal of Academic Research. – 2023. – T. 3. – No. 3. – pp. 120-128.
Abdurakhmonov Jurabek , Rahimov Nodir , Shakhanova Shakhnoza . Modern view on ascite in ovarian cancer. Journal of Biomedicine and Practice . 2022, vol . 7, issue 4, pp . 130-139