Wilczko Justyna, Szary Cezary, Bodziony Anna, Celejewski Krzysztof, Swieczkowski-Feiz Siavash, Napierala Marcin, Plucinska Dominika, Leszczynski Jerzy, Zawadzki Michal, Grzela Tomasz
Clinic of Phlebology, 02-034 Warsaw, Poland.
Center of Biostructure Research and the Department of General, Endocrinological and Vascular Surgery, Central University Hospital, Medical University of Warsaw, 02-091 Warsaw, Poland.
Diagnostics (Basel). 2023 Jul 30;13(15):2535. doi: 10.3390/diagnostics13152535.
Pregnancy is a well-known risk factor for venous insufficiency. However, even nulliparous women experience venous problems. Therefore, we aimed to assess the possible associations between the number of pregnancies, veins condition and treatment outcome in women with venous disease. The retrospective assessment concerned data of 297 women with diagnosed venous insufficiency. Based on their pregnancy history, the patients' records were divided into: nulliparous women (15.5%), those after 1-2 term pregnancies (57.9%) and those after ≥3 pregnancies (26.6%). The analysis concerned data from the diagnostics of the abdominal/pelvic and leg veins and the treatment results expressed as a symptoms/satisfaction score. Most of the nulliparous women developed venous disease due to mild anatomic abnormalities of the abdominal/pelvic veins. They responded to treatment (mostly unilateral embolization) very well. In the second group, the majority of the combined venous abnormalities responded to treatment with significant improvement, even after embolization alone, although nearly two-thirds still required further leg treatment. The third group was comprised of more advanced cases; nearly 40% of them with recurrence. In order to improve their condition, three-fourths of the cases required sequential treatment in both the pelvic and leg veins compartments. In conclusion, the number of pregnancies is a potent modifying factor in the pathogenesis of venous disease, especially in multiparous women. Together with abnormal venous anatomy, it may determine the treatment outcome.
怀孕是静脉功能不全的一个众所周知的风险因素。然而，即使是未生育的女性也会出现静脉问题。因此，我们旨在评估怀孕次数、静脉状况与静脉疾病女性治疗结果之间可能存在的关联。这项回顾性评估涉及297名被诊断为静脉功能不全的女性的数据。根据她们的怀孕史，患者记录被分为：未生育女性（15.5%）、有1 - 2次足月妊娠的女性（57.9%）和有≥3次妊娠的女性（26.6%）。分析涉及腹部/盆腔和腿部静脉诊断的数据以及以症状/满意度评分表示的治疗结果。大多数未生育女性因腹部/盆腔静脉的轻度解剖异常而患上静脉疾病。她们对治疗（大多为单侧栓塞）反应良好。在第二组中，大多数合并的静脉异常对治疗有显著改善，即使仅进行栓塞治疗，尽管近三分之二的患者仍需要进一步的腿部治疗。第三组由病情更严重的病例组成；其中近40%有复发情况。为了改善她们的病情，四分之三的病例需要在盆腔和腿部静脉区域进行序贯治疗。总之，怀孕次数是静脉疾病发病机制中的一个重要调节因素，尤其是在经产妇中。连同异常的静脉解剖结构，它可能决定治疗结果。
