THE ETIOLOGICAL FACTORS OF THE LOWER EXTREMITY VENOUS INSUFFICIENCY IN PREGNANCY

Öz

Objective: Number of pregnancy has a positive correlation with the development of lower limb venous insufficiency. We purpose to reveal the relation between the venous insufficiency in pregnancy and concomittant gestational features. Method: A retrospective analysis was performed using data collected from the database of our institution between January 2016-January 2021. 35 patients were included. The informations about age, in vitro fertilisation usage, polycystic ovary syndrome (PCOS), free T4 (fT4) and TSH levels, gestational diabetes mellitus (DM), other features and reports of Doppler ultrasound (USG) were investigated. Quantitative variables were analysed using Kolmogorov-Smirnov test. The relation between qualitative variables were analysed using x2 test. Descriptive statistics of qualitative variables were considered as mean±standard deviation, median (25-75 percentile), minimum-maximum. Descriptive statistics of quantitative variables were considered as frequency (%). P <0.05 was considered as statistically significant. Results: At the time of complain about leg pain and edema in lower extremities, 60% of patients were primigravid, mean age was 28.91±6.94. Mean value of the week of pregnancy was 28.71±7.92 (12-38). Mean value of TSH and fT4 were 1.74±0.86 mIU (0.23–4.07) and 13.78±3.15 pmol/mL (5.06-7.61) respectively. Twelve patients (34.3%) had venous insufficiency in Doppler USG, 3 (25%) of them were in 2nd trimester, 9(75%) were in 3rd trimester. 41.6% had normal delivery and 58.3% had cesarian section previously. fT4/ TSH ratio was 9.98 in Doppler USG positive group and in 3rd trimester had TSH and fT4 level as 1.55±0.44 and 14.62±2.14 respectively. Conclusion: There wasn’t a close relation between symptoms and venous insufficiency in Doppler USG neither between venous insufficiency and number of pregnancy or previous method of delivery. Even though venous insufficiency increases in the 3rd trimester, venous insufficiency didn’t correlate with TSH and fT4 levels. The ratio of fT4/TSH was sligtly higher in patients with venous insufficiency.

Anahtar Kelimeler

• Venous Insufficiency
• Pregnancy
• Thyroid Hormone

GEBELİKTE ALT EKSTREMİTE VENÖZ YETMEZLİĞİNİN ETYOLOJİK FAKTÖRLERİ

Öz

Amaç: Gebelik sayısı, alt ekstremite venöz yetmezlikle pozitif korelasyon gösterir. Çalışmamızda gebelikteki venöz yetmezliğin, gebeliğe eşlik eden özellikler ile korelasyonunu incelemeyi amaçladık. Yöntem: Ocak 2016- Ocak 2021 arasında hastanemize başvuran 35 hasta retrospektif olarak incelendi. Yaş, in vitro fertilizasyon, PCOS, sT4 ve TSH düzeyleri, gestasyonel DM ve diğer özellikler ile Doppler USG raporları incelendi. Nicel değişkenler Kolmogorov-Smirnov testiyle incelendi. Nitel değişkenler x2 test ile incelendi. Tanımlayıcı istatistikler, ortalama±standard sapma, median (25-75 yüzdelik), minimum-maksimum olarak değerlendirildi. Nicel değişkenlerin tanımlayıcı istatistiği ise frekans (%) olarak değerlendirildi. P<0.05 istatistiksel anlamlı kabul edildi. Bulgular: Bacak ağrısı ve ödemi gelişmesi anında, %60 hasta primigraviddi. Ortalama yaş 28.91±6.94 idi. Ortalama gebelik haftası 28.71±7.92 (12-38) idi. Ortalama TSH ve sT4 değeri, 1.74±0.86 mIU (0.23–4.07) ve 13.78±3.15 pmol/mL (5.06-7.61) idi. On iki hastada (%34) Doppler USG’de venöz yetmezlik mevcuttu. Bu hastaların 3’ü (%25) 2. trimester, 9’u (%75) 3. trimesterdeydi. % 41.6’sı normal doğum ve %58.3’ü Cesarian ile daha önce doğum yapmıştı. ST4/TSH oranı, Doppler pozitif grupta 9.98 idi. 3. trimesterde TSH ve sT4 düzeyleri sırasıyla 1.55±0.44 ve 14.62±2.14 idi. Sonuç: Semptom varlığı ve Doppler USG’de venöz yetmezlik oluşu arasında yakın bir ilişki tespit edilemedi. Aynı şekilde venöz yetmezlik ile gebelik sayısı ve önceki doğum metodu arasında yakın ilişki bulunamadı. Venöz yetmezlik 3. trimesterde artsa da, venöz yetmezlik TSH ve sT4 düzeyleri ile korelasyon göstermiyordu. ST4/TSH oranı venöz yetmezlik gösteren gebelerde ılımlı artmıştı.

Anahtar Kelimeler

• Venöz Yetmezlik
• Gebelik
• Tiroid Hormonu

Kaynakça

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