- Treatment of atypical forms of progressive varicose veins in pregnant women (varicose veins of the inguinal canal)
Treatment of atypical forms of progressive varicose veins in pregnant women (varicose veins of the inguinal canal)
HEALTH OF WOMAN. 2017.5(121):57–62; doi 10.15574/HW.2017.121.54
Antonyuk-Kysil V. М., Dziubanovskyi І. Ya., Yenikeeva V. M., Lichner S. І., Lypnyi V. M., Semeniuk М. V.
PI «Rivne Regional Perinatal Center»
LLC «LOKE», Rivne
SHEI «Ternopil State Medical University named after I.Ya. Gorbachevsky»
The objective: development and implementation of the use of duplex scanning data for safe treatment of various forms of primary progressive varicose veins of the inguinal canal (IIVIII) in the II-III trimesters of pregnancy.
Materials and methods. On the basis of the communal institution «Regional Perinatal Center» of the Rivne Regional Council, from the beginning of 2013 to January 2017 inclusive, 14,093 patients gave birth. Among them, 825 (5.85%) were diagnosed with progressive primary multifocal varicose disease of the lower limbs C2-4s, Ep, As, p, Pr (clinical class according to CEAP classification: C2 in 250, C3 in 566, C4 in 9 Pregnant women), perineum and external genitalia and inguinal canal and their combination. In 196 (23.76%) pregnant women, this pathology was detected in the first pregnancy, in 401 (48.6%) patients – during pregnancy, and in 228 (27.64%) patients – in subsequent pregnancies (two or more) .
Results. The data of surgical treatment of 54 pregnant women who agreed to carry out the operation according to the indications and methods developed by us in the II-III trimesters with PPVRVPK, both in isolated form and in combination with multifocal dilatation of the veins of the lower extremities, external genital organs and perineum . The main accessible, safe, non-invasive method of examining veins in pregnant women for establishing with a high probability of diagnosis and obtaining information on the results of treatment in the postoperative period is duplex scanning. 54 pregnant women with a positive result of treatment in all patients were operated on. There were no complications from both the fetuses and pregnant women, which is confirmed by stable within the limits of the norm indicators of cardiotocography, blood flow in the artery of the umbilical cord, the middle cerebral artery of the fetuses, internal iliac arteries of pregnant women according to duplex scanning data.
The conclusion. In the analysis of the results of surgical treatment, a high (100%) safety was confirmed for both the fetus and the pregnant woman with a 100% positive clinical result in the postoperative period.
Key words: progressive varicose veins of the inguinal canal (PVVIC), venous duplex scan, surgical treatment of PVVIC in pregnant women.
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