Jornal Vascular Brasileiro
https://jvascbras.org/journal/jvb/article/doi/10.1590/S1677-54492010000200004
Jornal Vascular Brasileiro
Original Article

Gestação e varizes de membros inferiores: prevalência e fatores de risco

Pregnancy and lower limb varicose veins: prevalence and risk factors

Newton de Barros Junior; Maria Del Carmen Janeiro Perez; Jorge Eduardo de Amorim; Fausto Miranda Junior

http://dx.doi.org/10.1590/S1677-54492010000200004 J Vasc Bras, vol.9, n2, p.29-35, 2010
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Resumo

Contexto: Durante e após a gestação, as varizes dos membros inferiores têm aspectos peculiares, tais como o seu aparecimento, a precocidade de seu desenvolvimento, a intensidade e, no puerpério, a rapidez com que regridem. Esses aspectos têm influenciado os estudos para a compreensão dessa patologia. Objetivo: Verificar a prevalência das varizes dos membros inferiores em gestantes e os fatores de risco mais relevantes envolvidos. A prevalência na gestação é alta, atingindo cerca de 70%, quando se consideram todos os tipos de varizes. Essa alta prevalência decorre principalmente do aumento nas taxas dos estrógenos e progestágenos que ocorre durante a gravidez. Material e método: Foram avaliadas 352 gestantes no período pré-natal, durante 14 meses, escolhidas ao acaso. A doença varicosa foi diagnosticada clinicamente e classificada segundo os critérios de Widmer em varizes tronculares, reticulares e telangiectasias e reclassificadas pela classificação CEAP, segundo o critério clínico. Os resultados de prevalência e fatores de risco foram submetidos às análises univariada e multivariada. Resultados: A prevalência da doença varicosa, quando considerados todos os tipos de varizes, foi de 72,7% (256 gestantes). As 96 gestantes (27,3%) que não apresentaram doença varicosa foram consideradas, para análise estatística, como controle. Os fatores de risco de significância, após análise multivariada, foram: antecedente familiar positivo e idade. Conclusão: A prevalência da doença varicosa durante a gestação e os fatores de risco envolvidos indicam a necessidade de divulgação dessa patologia entre os profissionais envolvidos na prevenção e manutenção da saúde da mulher, especialmente aquelas em período fértil.

Palavras-chave

Varizes, gestação, epidemiologia, veias varicosas

Abstract

Background: During and after pregnancy, lower limb varicose disease presents specific features that have influenced the conduction of studies designed to provide a better understanding of the condition. Such features include the appearance of lower limb varicose veins, their early development and intensity, and their rapid regression after delivery. Objective: To assess the prevalence of lower limb varicose disease during pregnancy and to identify the main associated risk factors. Prevalence of varicose disease during pregnancy is high, affecting almost 70% of pregnant women considering all types of varicose disease. This high prevalence is mainly caused by the increase in the estrogen and progesterone levels during pregnancy. Material and method: We analyzed 352 pregnant women during prenatal follow-up. The subjects were randomly selected during a 14-month period. Varicose disease was clinically identified and classified according to Widmer's criteria: trunk varicose veins, reticular varicose veins, and telangiectasias; being reclassified according to the criteria of the CEAP clinical classification. The results of prevalence and risk factors were statistically analyzed using univariate and multivariate analyses. Results: Considering all types of varicose veins, prevalence of varicose disease was 72.7% (256 pregnant women). Only 27.3% (96) of pregnant women did not have varicose disease (C0), and this group was considered the control group. After multivariate analysis, the main risk factors were: family history and pregnant women's age. Conclusion: The high prevalence of varicose disease and the associated risk factors suggest the need of providing the health professionals involved in women's health care, especially during the fertile period, with information on this disease.

Keywords

Pregnancy, varicose veins, epidemiology, veins

References

Callam MJ. Epidemiology of varicose veins. Br J Surg. 1994;81:167-73.

Bowes K, Riterband SH, Andrews JE. Demonstration by infra-red photography of the superficial veins in the pregnant and nonpregnant woman. J Obstet Gynaecol Br Emp. 1948;55:285-92.

Bassi G. Les varices des membres inférieurs. 1967.

Boivin P, Hutinel B. Varices and pregnancy. J Mal Vasc. 1987;12:218-21.

Griton P, Escalier-Imbert M, Cuffit A. Varicose disease: Epidemiologic study apropos of 1600 cases. Phlebologie. 1987;40:923-9.

Valdevenito R, Silva C, Yañez N. Estudio epidemiologico de pacientes operados de varices en el Hospital Sanatorio de Valparaiso. Bol Hosp San Juan de Dios. 1989;36:3-11.

Barile C, Merlo M, Buzzacchino A, Pegoraro M. Physiopathology of varices during pregnancy. Minerva Ginecol. 1990;42:117-21.

Dindelli M, Basellini A, Rabaiotti E. Epidemiological analysis of the incidence of varicose pathology in pregnancy. Ann Ostet Ginecol Med Perinat. 1990;111:257-64.

Sciannameo F, Ronca P, Alberti D, Madami C. Varicose veins in pregnancy: physiopathology and therapeutic approach. Minerva Ginecol. 1993;45:539-43.

Eklöf B, Rutherford RB, Bergan JJ. Revision of the CEAP classification for chronic venous disorders: consensus statement. J Vasc Surg. 2004;40:1248-52.

Kerr MG, Scott DB, Samuel E. Studies of the inferior vena cava in late pregnancy. Br Med J. 1964;1:532-3.

Samuel E. The inferior vena cavogram in pregnancy: Radiological aspects. Proc R Soc Med. 1964;57:702-4.

Sumner DS. Venous dynamics: varicosities. Clin Obstet Gynecol. 1981;24:743-60.

Arruda S. Aspectos etiopatogênicos das varizes na gravidez. Rev Bras Cardiovasc. 1966;2:125-34.

Basellini A, Agus GB, Antonucci E, Papacharalambus D. Varices in pregnancy (an up-date). Ann Ostet Ginecol Med Perinat. 1985;106:337-41.

McLennan CE. Antecubital and femoral venous pressure in normal and toxemic pregnancy. Am J Obstet Gynecol. 1943;45:568-91.

Rezende J, Linhares E. Endocrinologia do ciclo gravídico. Obstetrícia. 1974:116-29.

McCausland AM, Holmes F, Trotter Junior AD. Venous distensibility during the menstrual cycle. Am J Obstet Gynecol. 1963;86:640-5.

Piulachs P, Vidal-Barraquer F, Biel JM. Pathogenesis of varicose veins in pregnancy. Lyon Chir. 1952;47:236-78.

Charles-Edouard Otrante D, Zacca Pena E, Ariosa Coloma MC, Robaina Jorge F. Relative risk in varicose veins and pregnancy. Angiologia. 1980;32:66-9.

Grismondi GL. Treatment of phlebopathies caused by stasis in pregnancy. Minerva Ginecol. 1981;33:221-3.

Boivin P, Cornu-Thenard A, Charpak Y. Pregnancy-induced changes in lower extremity superficial veins: an ultrasound scan study. J Vasc Surg. 2000;32:570-4.

Nahoum JC, Barcellos JM. Placenta: Cordão umbilical. Sistema amniótico. Obstetrícia. 1974:44.

Maffei FHA, Magaldi C, Pinho SZ. Varicose veins and chronic venous insufficiency in Brazil: prevalence among 1755 inhabitants of a country town. Int J Epidemiol. 1986;15:210-7.

Ludwig H. Pregnancy varicoses. Zentralbl Phlebol. 1964;126:22-8.

Bertone C. The puerperal varicose syndrome. Minerva Med. 1961;52:655-9.

Cornu-Thenard A, Boivin P, Baud JM, De Vicenzi I, Carpentier PH. Importance of the familial factor in varicose disease: Clinical study of 134 families. J Dermatol Surg Oncol. 1994;20:318-26.

Rezende J, Coslovsky S. Repercussões na gravidez sobre o organismo. Obstetrícia. 1974:130-58.

Silveira PRM. Estudo estrutural da veia safena magna normal e varicosa. Rev Angiol Cir Vasc. 1993;2:116-33.

Beaglehole R. The epidemiology of venous disease. Phlebology. 1995:25-8.

Widmer LK. Peripheral venous disorders: prevalence and socio-medical importance; observations in 4529 apparently healthy persons. 1978.

Guerrini S, Marietta G, Ferreri G. Varices and pregnancy: Statistical evaluation. Minerva Ginecol. 1987;39:503-10.

Lake M, Pratt GH, Wright IS. Arteriosclerosis and varicose veins: occupational activities and others factors. J Am Med Assoc. 1942;119:696-701.

Mullane DJ. Varicose veins in pregnancy. Am J Obstet Gynecol. 1952;63:620-8.

Donato VM, Nejamkim J. Varices and pregnancy: their treatment. Prensa Med Argent. 1956;43:551-7.

Dindelli M, Parazzini F, Basellini A, Rabaiotti E, Corsi G, Ferrari A. Risk Factors for varicose disease before and during pregnancy. Angiology. 1993;44:361-7.

Drury M. Varicose veins in pregnancy. Br Med J. 1965;2:304.

Guberan E, Widmer LK, Glaus L. Causative factors of varicose veins: myths and facts. An epidemiological study of 610 women. Vasa. 1973;2:115-20.

Burkitt DP. Varicose veins, deep vein thrombosis and hemorrhoids: epidemiology and suggested aetiology. Br Med J. 1972;2:556-61.

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