Skudder P A, Farrington D T
Department of Surgery, Uniformed Services University of the Health Sciences, Schenectady, NY.
Semin Dermatol. 1993 Jun;12(2):72-7.
Pregnancy is associated with several changes in venous physiology. These include relaxation of venous wall tone and increased lower extremity venous pressure. As a result of these changes, varicose veins, spider telangiectasias, purpura, and other superficial findings may develop. Treatment of these conditions is conservative during pregnancy. As the changes in venous hemodynamics resolve over several weeks after delivery, partial or complete regression may occur. In cases where persistent abnormality persists well after delivery, more definitive therapy may be considered. Pregnancy is also associated with a mild hypercoagulable state, and there may be trauma to venous endothelium associated with delivery. Coupled with the relative stasis resulting from pelvic venous compression by the uterus and from decreases in venous tone, these changes cause an increased risk of deep vein thrombosis in late pregnancy and the peripartum period. Anticoagulation with heparin is required as coumadin and fibrinolytic agents are considered to be hazardous.
妊娠与静脉生理的多种变化相关。这些变化包括静脉壁张力松弛和下肢静脉压力升高。由于这些变化，可能会出现静脉曲张、蜘蛛状毛细血管扩张、紫癜及其他浅表症状。孕期对这些病症的治疗是保守的。随着分娩后数周静脉血流动力学变化的消退，症状可能会部分或完全消退。如果分娩后长时间仍存在持续异常，可考虑更确切的治疗方法。妊娠还与轻度高凝状态有关，分娩时可能会对静脉内皮造成损伤。再加上子宫对盆腔静脉的压迫以及静脉张力降低导致的相对血流淤滞，这些变化使妊娠晚期和围产期深静脉血栓形成的风险增加。由于华法林和纤溶药物被认为具有危险性，因此需要用肝素进行抗凝治疗。
