Actualización del tratamiento de la insuficiencia venosa en la gestación

  1. B. Rodríguez-Nora 1
  2. E. Álvarez-Silvares 1
  1. 1 Complexo Hospitalario Universitario de Ourense, Ourense, España
Revista:
Semergen: revista española de medicina de familia

ISSN: 1138-3593

Ano de publicación: 2018

Número: 4

Páxinas: 262-269

Tipo: Artigo

DOI: 10.1016/J.SEMERG.2017.11.003 DIALNET GOOGLE SCHOLAR

Outras publicacións en: Semergen: revista española de medicina de familia

Obxectivos de Desenvolvemento Sustentable

Resumo

Chronic venous insufficiency is a long-term pathological condition resulting from anatomical or functional alterations of the venous system. This leads to the appearance of symptoms and physical signs that affect a large part of the population and particularly pregnant women, due to the physiology of pregnancy. The few published studies on the use of pharmacological treatments of venous insufficiency in this group of the population, often makes the management of this condition difficult in routine clinical practice. A review is presented in this article, with all the latest updates in the treatment of this condition during pregnancy. There are numerous general, and some pharmacological, recommendations, that we can safely offer the pregnant patient.

Referencias bibliográficas

  • B. Eklof, M. Perrin, K.T. Delis, R.B. Rutherford, P. Gloviczki Updated terminology of chronic venous disorders: The VEIN-TERM transatlantic interdisciplinary consensus document J Vasc Surg., 49 (2009), pp. 498-551 View Record in ScopusGoogle Scholar
  • Y. Rhabi, C. Charras-Arthapignetic, J.C. Gris, J. Ayoub, J.F. Brun, F.M. Lopez, et al. Lower limb vein enlargement and spontaneous blood flow echogenicity are normal sonographic findings during pregnancy J Clin Ultrasound., 28 (2000), pp. 407-413 Google Scholar
  • C. Miquel Abbada, R. Rial Horcajo, M.D. Ballesteros Ortegac, C. García Madrida Guías de práctica clínica en enfermedad venosa crónica Sociedad Española de Angiología y Cirugía Vascular Angiología, Madrid (2015) [consultado 25 Jul 2017]. Disponible en: http://www.capitulodeflebologia.org/media/Guias-Practica-Clinica-Enfermedad-Venosa-Cronica_431.pdf Google Scholar
  • A. Mashiah, V. Berman, H.H. Thole, S.S. Rose, S. Pasik, H. Schwarz, et al. Estrogen and progesterone receptors in normal and varicosesaphenous veins Cardiovasc Surg., 7 (1999), pp. 327-331 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • M. Ropacka-Leiak, J. Kasperczak, G.H. Breoborowicz Risk factors for the development of venous insufficiency of the lowerlimbs during pregnancy--part 1 Ginekol Pol., 83 (2012), pp. 939-942 Google Scholar
  • E. Carrasco Carrasco, S. Díaz Sanchez Recomendaciones para el manejo de la Enfermedad Venosa Crónica en Atención Primaria ID Médica (2015), pp. 12-16 View Record in ScopusGoogle Scholar
  • J.L. Beebe-Dimmer, J.R. Pfeifer, J.S. Engle, D. Schottenfeld The epidemiology of chronic venous insufficiency and varicose veins Ann Epidemiol., 15 (2005), pp. 175-184 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • S.C. Carr Current management of varicose veins Clin Obstet Gynecol., 49 (2006), pp. 414-426 CrossRefView Record in ScopusGoogle Scholar
  • A.N. Nicolaides Cardiovascular Disease Educational and Research Trust; European Society of Vascular Surgery; The International Angiology Scientific Activity Congress Organization; International Union of Angiology; Union Internationale de Phlebologie at the Abbaye des Vaux de Cernay. Investigation of chronic venous insufficiency. A consensus statement (France, March 5-9, 1997) Circulation., 102 (2000), pp. E126-E163 View Record in ScopusGoogle Scholar
  • P.J. Galambosi, M. Gissler, R.J. Kaaja, U.M. Ulander Incidence and risk factors of venous thromboembolism during postpartum period: a population-based cohort-study Acta Obstet Gynecol Scand., 96 (2017), pp. 852-861 CrossRefView Record in ScopusGoogle Scholar
  • L. Herranz de la Morena Índice tobillo brazo para la evaluación de la enfermedad arterial periférica Av Diabetol., 21 (2005), pp. 224-226 Google Scholar
  • E. Viver, L.I. Roig, O. Pastor, E. Roche, J. Cabrera, M. Matas, et al. Tratamientos I y II en la insuficiencia venosa crónica. Indicaciones y resultados An Cir Card Cir Vasc., 10 (2004), pp. 118-136 View Record in ScopusGoogle Scholar
  • F.T. Padberg Jr., M.V. Johnston, S.A. Sisto Structured exercise improves calf muscle pump function in chronic venous insufficiency: a randomized trial J Vasc Surg., 39 (2004), pp. 79-87 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • Y.M. Kan, K.T. Delis Hemodynamic effects of supervised calf muscle exercise in patients with venous leg ulceration: a prospective controlled study Arch Surg., 136 (2001), pp. 1364-1369 View Record in ScopusGoogle Scholar
  • R.M. Smyth, N. Aflaifel, A.A. Bamigboye Interventions for varicose veins and leg oedema in pregnancy Cochrane Database Syst Rev., 10 (2015), p. CD001066, 10.1002/14651858.CD001066.pub3 View Record in ScopusGoogle Scholar
  • L. Norgren Elastic compression stockings-an evaluation with foot volumetry, strain-gauge plethysmography and photoplethysmography Acta Chir Scand., 154 (1988), pp. 505-507 View Record in ScopusGoogle Scholar
  • N. Labropoulos, M. Leon, N. Volteas, A.N. Nicolaides Acute and long-term effect of elastic stockings in patients with varicose veins Int Angiol., 13 (1994), pp. 119-123 View Record in ScopusGoogle Scholar
  • O. Lapiedra Clasificación CEAP. Criterios de selección/manejo de prioridades. Insuficiencia venosa crónica. Conceptos actuales An Cir Card Cir Vasc, 10 (2004), pp. 102-105 View Record in ScopusGoogle Scholar
  • M.J. Martinez-Zapata, R.W. Vernooij, S.M. Uriona Tuma, A.T. Stein, R.M. Moreno, E. Vargas, et al. Phlebotonics for venous insufficiency Cochrane Database of Systematic Reviews., 4 (2016), p. CD003229, 10.1002/14651858.CD003229.pub3 View Record in ScopusGoogle Scholar
  • F.A. Allaert Meta-analysis of the impact of the principal venoactive drugs agents on malleolar venous edema Int Angiol., 31 (2012), pp. 310-315 View Record in ScopusGoogle Scholar
  • A.N. Wadworth, D. Faulds Hydroxyethylrutosides. A review of its pharmacology, and therapeutic efficacy in venous insufficiency and related disorders Drugs, 44 (1992), pp. 1013-1032 CrossRefView Record in ScopusGoogle Scholar
  • L.C. Aguilar Trastornos circulatorios de las extremidades inferiores. Diagnóstico y Tratamiento OFFARM., 22 (2003), pp. 118-128 View Record in ScopusGoogle Scholar
  • M. Unkauf, D. Rehn, J. Klinger, S. de la Motte, K. Grossmann Investigation of the efficacy of oxerutins compared to placebo in patients with chronic venous insufficiency treated with compression stockings Arzneimittelforschung., 46 (1996), pp. 478-482 View Record in ScopusGoogle Scholar
  • C. Scallon, S.E. Bell-Syer, Z. Aziz Flavonoids for treating venous leg ulcers Cochrane Database Syst Rev. (2013) CD006477. DOI: 10.1002/14651858.CD006477.pub2 Google Scholar
  • C.E. Quijano, E. Abalos Conservative management of symptomatic and/or complicated haemorrhoids in pregnancy and the puerperium Cochrane Database of Systematic Reviews., 6 (2005), p. CD004077, 10.1002/14651858.CD004077.pub2 View Record in ScopusGoogle Scholar
  • D. Longiave, C. Omini, S. Nicosia, F. Berti The mode of action of aescin on isolated veins: relationship with PGF2 alpha Pharmacol Res Commun., 10 (1978), pp. 145-152 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • C. Diehm, H.J. Trampisch, S. Lange, C. Schmidt Comparison of leg compression stocking and oral horse-chestnut seed extract therapy in patients with chronic venous insufficiency Lancet., 347 (1996), pp. 292-294 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • R. Bush, A. Comerota, M. Meissner, J.D. Raffetto, S.R. Hahn, K. Freeman Recommendations for the medical management of chronic venous disease: The role of Micronized Purified Flavanoid Fraction (MPFF) Phlebology., 32 (1 supp) (2017), pp. 3-19 CrossRefView Record in ScopusGoogle Scholar
  • P.C. Smith Daflon 500 mg and venous leg ulcer: new results from a meta-analysis Angiology., 56 (Suppl 1) (2005), pp. S33-S39 CrossRefView Record in ScopusGoogle Scholar
  • J.J. Guilhou, O. Dereure, L. Marzin, P. Ouvry, F. Zuccarelli, C. Debure, et al. Efficacy of Daflon 500 mg in venous leg ulcer healing: a double-blind, randomized, controlled versus placebo trial in 107 patients Angiology., 48 (1997), pp. 77-85 CrossRefView Record in ScopusGoogle Scholar
  • E. Pósfai, F. Bánhidy, A.E. Czeizel Teratogenic effect of hydroxyethylrutoside, a flavonoid derivate drug--a population-based case-control study J Matern Fetal Neonatal Med., 27 (2014), pp. 1093-1098 CrossRefView Record in ScopusGoogle Scholar
  • K. Buckshee, D. Takkar, N. Aggarwal Micronized flavonoid therapy in internal hemorrhoids of pregnancy Int J Gynaecol Obstet., 57 (1997), pp. 145-151 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • A.A. Bamigboye, R.M.D. Smyth Interventions for varicose veins and leg oedema in pregnancy Eur J Obstet Gynecol Reprod Biol., 129 (2006), pp. 3-8 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • J.R. Pfeifer Sclerotherapy in Pfenninger: Procedures for primary care medicine Mosby-Year Book, Inc, Houston (1994) Google Scholar
  • Alguire PC, Scovell S. Overview and management of lower extremity chronic venous disease. En: Eidt J, Mills JL. editores. UpToDate [consultado 7 Ago 2017]. Disponible en: http://www.uptodate.com/contents/overview-and-management-of-lower-extremity-chronic-venous-disease. Google Scholar
  • N.L. González González, V. Tejerizo García, F. Medina Morales, D. Corredera Hernández, D. Holgado Sánchez, L.C. Tejerizo López Insuficiencia venosa periférica y tromboflebitis superficial Fabré González (Ed.), Asistencia a las complicaciones médicas y quirúrgicas en el embarazo (1. ªed.), Adalia, Madrid (2007), pp. 159-174 View Record in ScopusGoogle Scholar
  • S. Díaz Sánchez, F.J. Gordillo López, A.I. González González, N. Puche López, T. Fernández Vicente Guía clínica sobre patología arterial y venosa FMC. (2001), pp. 9-23 (Protocolos 3) Google Scholar
  • M.A. Villa i Coll, J. Fernández Parcés, M.C. Fernández Aramburu Insuficiencia venosa crónica de extremidades inferiores FMC., 2 (1995), pp. 13-22 Google Scholar
  • N.J. London, R. Nash ABC of arterial and venous disease. Varicose veins BMJ., 320 (2000), pp. 1391-1394 View Record in ScopusGoogle Scholar
  • M.L. Navas Hergueta, A.N. López Laguna Insuficiencia venosa crónica AMF., 7 (2011), pp. 509-514 View Record in ScopusGoogle Scholar
  • J.T. Hobbs The pelvic congestion syndrome Br J Hosp Med., 43 (1990), pp. 200-206 View Record in ScopusGoogle Scholar
  • A. Lakshmi, P. Marsh, J. Holdstock, C. Harrison, F. Hussain, A. López Pelvic vein embolisation in the management of varicose veins Cardiovasc Intervent Radiol., 31 (2008), pp. 1159-1164 Google Scholar
  • L.L. Veltman, D.R. Ostergard Thrombosis of vulvar varicosities during pregnancy Obstet Gynecol., 39 (1972), pp. 55-56 View Record in ScopusGoogle Scholar
  • P.A. Gearhart, P.J. Levin, M.O. Schimpf Expanding on earlier findings A vulvar varicosity grew larger with each pregnancy Am J Obstet Gynecol., 204 (2011), p. 89 e1-2 View Record in ScopusGoogle Scholar
  • M. Romero Hemorroides Rev Sdad Valenciana Patol Dig, 20 (2001), pp. 81-83 View Record in ScopusGoogle Scholar
  • Hurtado Sánchez F. Insuficiencia venosa y gestación. Servicio de Obstetricia y Ginecología, Hospital Universitario Virgen de las Nieves Granada [consultado 12 Jul 2017]. Disponible en: http://www.hvn.es/servicios_asistenciales/ginecologia_y_obstetricia/ficheros/cr.insuficiencia_venosa_gestacion.pdf. Google Scholar
  • D. Imbaquingo, F. Carrera, P. Cisnero Eficacia y seguridad de la embolización en pacientes con diagnóstico de varices pélvicas Angiología., 68 (2016), pp. 388-395 ArticleDownload PDFCrossRefView Record in ScopusGoogle Scholar
  • Johnson NR. Vulvovaginal varicosities and pelvic congestion syndrome. UpToDate 2017. [consultado 12 Jul 2017]. Disponible en: http://www.uptodate.com/contents/vulvovaginal-varicosities-and-pelvic-congestion-syndrome. Google Scholar
  • O. D’archambeau, M. Maes, A.M. de Schepper The pelvic congestion symdrome: role of the nutcrackert phenomenom. And results of endovascular treatment JBR-BTR., 87 (2004), pp. 1-8 View Record in ScopusGoogle Scholar
  • T. Nicholson, A. Basile Pelvic congestion syndrome, who should we treat and how? Tech Vasc Intervent Radiol., 9 (2006), pp. 19-23 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • M.E. Soysal, S. Soysal, K. Vicdan, S. Ozer A randomized controlled trial of groselin and medroxyprogesterone acetate in treatment of pelvic congestion Hum Reprod., 16 (2001), pp. 931-939 View Record in ScopusGoogle Scholar
  • C. Hodgkinson Hemorrhage from ruptured utero-ovarian veins during pregnancy J Am Med Assoc., 148 (1952), pp. 277-278 CrossRefView Record in ScopusGoogle Scholar
  • Y. Emergui Zrihen, T. Figueras Falcón, J. García Hernández, L. Gutiérrez García, C. Martel Santiago Rotura espontánea de varices uterinas como causa de hemoperitoneo en la segunda mitad de la gestación Prog Obstet Ginecol., 59 (2016), pp. 75-77 View Record in ScopusGoogle Scholar