PERINATAL OUTCOMES IN WOMEN WITH VARICOSE VEINS IN A COVID-19 PANDEMIC

Objective. To evaluate pregnancy and labor outcomes in women with varicose veins in a COVID-19 pandemic.

Material and methods. Sixty-eight pregnant women were included in the study, 38 of whom used compression stockings (main group), and 30 patients were included in the comparison group. During follow-up, 8/38 (21 %) patients from the main group and 9/30 (30 %) patients from the comparison group had COVID-19 infection. All patients underwent clinical, laboratory, gynecologic, and ultrasound examinations. The primary endpoints of the study were maternal complications of pregnancy and labor. Secondary endpoints were pathologic conditions and perinatal parameters related to the fetus.

Results. The number of cases of preterm labor, utero-placental blood flow disorders, preeclampsia, and gestational diabetes mellitus was higher in the control group compared to the comparison group (p > 0.99). Fetal distress developed in 2/30 (6.7 %) observations from the comparison group of laboring women (p = 0.605). The highest number of infants (70–75 %) who scored 9 Apgar score at the 5th minute of life was recorded in the main group. Comparative analysis of pregnant women with mild COVID-19 and without COVID-19 found no significant effect of coronavirus infection on obstetric and perinatal outcomes.

Conclusion. The results of this study confirm the information about the adverse effect of concomitant varicose veins on the outcomes of pregnancy and childbirth. These findings support the rationale for the combined use of compression and phlebotropic pharmacological therapy in pregnant women with varicose veins.

1. Cardiovascular complications of COVID-19 among pregnant women and their fetuses: a systematic review / S. Yaghoobpoor, M. Fathi, K. Vakili [et al.] // J. Clin. Med. – 2022. – Vol. 11, № 20. – P. 6194.

2. Review of the clinical characteristics of coronavirus disease 2019 (COVID-19) / F. Jiang, L. Deng, L. Zhang [et al.] // J. Gen. Intern. Med. – 2020. – Vol. 35, № 5. – P. 1545–1549.

3. COVID-19 and the cardiovascular system / Y. Y. Zheng, Y. T. Ma, J. Y. Zhang [et al.] // Nat. Rev. Cardiol. – 2020. – Vol. 17, № 5. – P. 259–260.

4. The “scar” of a pandemic: cumulative incidence of COVID-19 during the first trimester of pregnancy / S. Cosma, F. Borella, A. Carosso [et al.] // J. Med. Virol. – 2021. – Vol. 93, № 1. – P. 537–540.

5. Pregnancies recovered from SARS-CoV-2 infection in second or third trimester / P. V. Gracia, L. C. Caballero, J. Sánchez [et al.] // Ultrasound Obstet. Gynecol. – 2020. – Vol. 56, № 5. – P. 777–778.

6. Pregnancy-related venous thromboembolism: risk and the effect of thromboprophylaxis / F. Lussana, M. Coppens, M. Cattaneo [et al.] // Thromb. Res. – 2012. – Vol. 129, № 6. – P. 673–680.

7. Cardiovascular diseases and its associated comorbid conditions as factors influencing on adverse outcomes of pregnancy – analysis of the results of the BEREG pregnant women registry / R. I. Struk, S. A. Burns, M. P. Filippova [et al.] // Ther. archive. – 2018. – Vol. 90, № 1. – P. 9–16 (in Russ.).

8. Revision of the CEAP classification for chronic venous disorders: consensus statement / B. Eklof, R. B. Rutherford, J. J. Bergan [et al.] // J. Vasc. Surg. – 2004. – Vol. 40, № 6. – P. 1248–1252.

9. ACOG committee opinion No. 650. Physical activity and exercise during pregnancy and the postpartum period // Obstet. Gynecol. – 2015. – № 126. – P. e135–142.

10. Exercise during pregnancy: a comparative review of guidelines / I. Tsakiridis, D. R. Bakaloudi, A. C. Oikonomidou [et al.] // Perinat. Med. – 2020. – Vol. 48, № 6. – P. 519–525.

11. Smyth, R. M., Aflaifel N., Bamigboye A. A. Interventions for varicose veins and leg oedema in pregnancy // Cochrane Database Syst. Rev. – 2015. – Vol. 19, № 10. – CD001066.

12. Khryshchanovich, V. Y., Skobeleva N. Y. Prevalence and risk factors of varicose vein disease in pregnant woman // News of medical and biological sciences. – 2023. – Vol. 23, № 1. – P. 25–32 (In Russ.).

13. Major risk factors for chronic venous disease development in women: is childbirth among them? / M. Matić, A. Matić, Z. Gajinov [et al.] // Women Health. – 2019. – Vol. 59, № 10. – P. 1118–1127.

14. Management of chronic venous disease: clinical practice guidelines of the European Society for Vascular Surgery (ESVS) / C. Wittens, A. H. Davies, N. Bækgaard [et al.] // Eur. J. Vasc. Endovasc. Surg. – 2015. – Vol. 49, № 6. – P. 678–737.

15. Effects of the COVID-19 pandemic on maternal and perinatal outcomes: a systematic review and meta-analysis / B. Chmielewska, I. Barratt, R. Townsend [et al.] // Lancet Glob. Health. – 2021. – Vol. 9, № 6. – P. e759–772.

16. Mirbeyk, M., Saghazadeh A., Rezaei N. A systematic review of pregnant women with COVID-19 and their neonates // Arch. Gynecol. Obstet. – 2021. – Vol. 304, № 1. – P. 5–38.