RESUMO
PURPOSE: Quantify the volume and diameter of veins in the lower limbs of primigravidae and associate the presence of venous signs and symptoms with the vascular measurements. METHODS: A cross-sectional study assessed 64 lower limbs of 32 healthy women of whom 16 were primigravidae between 22 and 36 weeks pregnant, and 16 nulligravidae. The women were submitted to physical assessment, air plethysmography and vascular ultrasound. The volumes and diameters of the main veins in the lower limbs were compared between pregnant and non-pregnant women. In the group of pregnant women, the attempt was also made to associate such measurements to the presence of vascular signs and symptoms. RESULTS: The average venous volume of the lower limbs (110.1 ± 30.2 and 94.7 ± 27.3 mL; p = 0.036), as well as the diameters of the common femoral (12.72 ± 2.27 and 10.14 ± 1.24 mm; p < 0.0001), saphenous (4.81 ± 1.15 and 3.55 ± 0.98 mm; p < 0.0001) and popliteal (6.87 ± 1.68 and 5.36 ± 1.07 mm; p < 0.0001) veins were, respectively, greater in the pregnant women compared with the control group. In pregnant women with venous stasis symptoms, a venous diameter of the saphenous vein compared to those without no symptoms (5.05 ± 1.19 and 4.09 ± 0.70 mm; p = 0.011) was noted. CONCLUSIONS: Anatomical and functional changes in the venous system during pregnancy were detected by the air plethysmography and the vascular ultrasound in primigravidae. In pregnant women, the presence of venous stasis symptoms found an anatomical and functional substrate detected in the differences in diameter of the saphenous vein.
Assuntos
Extremidade Inferior/irrigação sanguínea , Síndrome Pós-Trombótica/patologia , Complicações Cardiovasculares na Gravidez/patologia , Veia Safena/patologia , Adolescente , Adulto , Estudos de Casos e Controles , Estudos Transversais , Feminino , Veia Femoral/anatomia & histologia , Veia Femoral/diagnóstico por imagem , Veia Femoral/fisiologia , Humanos , Extremidade Inferior/diagnóstico por imagem , Pessoa de Meia-Idade , Pletismografia , Veia Poplítea/anatomia & histologia , Veia Poplítea/diagnóstico por imagem , Veia Poplítea/fisiologia , Síndrome Pós-Trombótica/diagnóstico por imagem , Gravidez , Complicações Cardiovasculares na Gravidez/diagnóstico por imagem , Complicações Cardiovasculares na Gravidez/fisiopatologia , Veia Safena/diagnóstico por imagem , Veia Safena/fisiopatologia , Ultrassonografia , Adulto JovemRESUMO
Increased levels of factor VIII (FVIII) are a prevalent and independent risk factor for deep venous thrombosis (DVT). After a median of 10 years of the first DVT, we evaluated FVIII coagulation levels in 55 patients with DVT of the lower limbs and previous high levels of FVIII and in 74 controls. Subsequently, we analyzed the presence of post-thrombotic syndrome (PTS) in patients and its relationship with FVIII levels. After a median of 10 years of the first DVT, the FVIII levels were still significantly higher in patients when compared to controls (P < .001). Patients with severe PTS showed increased levels of FVIII when compared to patients with moderate or absent PTS (P < .001). We demonstrated a persistent increase in FVIII levels in a subset of patients with DVT, but in a lower magnitude after 10 years of the first DVT episode. Moreover, we observed a significant association between increased FVIII levels and severe PTS.