A differentiated approach to pregnancy planning in women with varicose veins of the lower extremities

Mozheiko L.F.; Tikhonovich E.V.

doi:https://doi.org/10.17116/rosakush2022220217

Mozheiko L.F.

Belarusian State Medical University

Tikhonovich E.V.

Belarusian State Medical University

A differentiated approach to pregnancy planning in women with varicose veins of the lower extremities

Authors:

Mozheiko L.F., Tikhonovich E.V.

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Journal: Russian Bulletin of Obstetrician-Gynecologist. 2022;22(2): 7‑12

DOI: 10.17116/rosakush2022220217

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To cite this article:

Mozheiko LF, Tikhonovich EV. A differentiated approach to pregnancy planning in women with varicose veins of the lower extremities. Russian Bulletin of Obstetrician-Gynecologist. 2022;22(2):7‑12. (In Russ.)
https://doi.org/10.17116/rosakush2022220217

Подписка 2026 Российский вестник акушера-гинеколога (Russian Bulletin of Obstetrician-Gynecologist)

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Abstract:

Purpose of the study. To improve perinatal outcomes in women with varicose veins of the lower extremities by using the developed method for predicting of placental disorders at the stage of pregnancy planning.

MATERIAL AND METHODS

To develop a mathematical model for predicting placental insufficiency in patients with varicose veins of the lower extremities, we examined 128 women with chronic diseases of the veins of the lower extremities who applied to prepare for a planned pregnancy, who underwent a comprehensive assessment of clinical and laboratory parameters, including levels of vascular endothelial growth factor (VEGF), endothelin-1, C-reactive protein (CRP), vitamin 25(OH)D, parameters of the hemostatic system.

RESULTS

The following indicators have high prognostic significance: VEGF >25.75 pg/ml (sensitivity 89.4%, specificity 76.5%), endothelial-on-1 >4.75 pg/ml (sensitivity 78.7%, specificity 66.7%), CRP >4.05 mg/l (sensitivity 78.7%, specificity 71.6%), fibrinogen >4.715 g/ml (sensitivity 72.6%, specificity 70.4%), D-dimers >141 ng/ml (sensitivity 72.3%, specificity 67.9%), vitamin D (25-OH vitamin D) <10.5 ng/ml (sensitivity 74.2%, specificity 67, 9%). A mathematical model was developed based on the determination of a set of clinical and laboratory parameters (area under the curve — AUC=0.94, 95% confidence interval 0.842—0.956; p<0.001). The optimal binary classification threshold is a cutoff point of 0.581. The probability of developing of placental insufficiency should be considered high if the specified threshold value is exceeded.

CONCLUSION

The use of the method for determining the probability of developing of placental insufficiency in women with varicose veins of the lower extremities allows, at the stage of preparation for a planned pregnancy, to carry out the most effective therapeutic and preventive measures aimingly in order to improve perinatal outcomes.

Keywords:

clinical class of chronic diseases of the veins of the lower extremities

varicose veins of the lower extremities

placental insufficiency

angiogenic factors

vascular endothelial growth factor

endothelin

Authors:

Mozheiko L.F.

Belarusian State Medical University

Tikhonovich E.V.

Belarusian State Medical University

Received:

09.09.2021

Accepted:

07.10.2021

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References:

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