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616.147.3-007.64:618.3 (1) |
Патология сердечно-сосудистой системы. Сердечно-сосудистые заболевания (975) |
SM ISO690:2012 CODREANU, Nadejda, GAŢCAN, Ştefan, MURŞIEV, Cristina. Evaluarea bolii varicoase în calitate de marker surogat al stărilor trombofilice în sarcină. In: Buletin de Perinatologie, 2015, nr. 3(67), pp. 49-54. ISSN 1810-5289. |
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Buletin de Perinatologie | ||||||
Numărul 3(67) / 2015 / ISSN 1810-5289 | ||||||
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CZU: 616.147.3-007.64:618.3 | ||||||
Pag. 49-54 | ||||||
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Background: A successful pregnancy outcome requires an efficient utero-placental vascular circulation. This system may be compromised by disorders of hemostasis associated with a prothrombotic state, such as thrombophilia. Thrombophilic disorders have been attributed to multiple complications that occur in pregnancy, such as preeclampsia, recurrent fetal loss, abruption placentae, still-birth and others. Also, recent studies demonstrated higher incidence of thrombophilia in people with varicose veins, suggesting an association between this diseases. As the screening of thrombophilia is expensive and the diagnosis is frequently established very late, when complications are installed, in this study we aimed to evaluate the relevance of using the varicose veins as an indirect marker of thrombophilia, the presence of which could lead to an early suspicion of the disorder and resulting in an early diagnosis, prophylaxis and treatment, reducing costs and morbidity in the same time. Materials and methods: The case control study is based on the data of 140 pregnant women admitted in the Department of Obstetrics of The Institute of Mother and Child in the period of 2011-2014. They were evaluated from the perspective of their obstetrical complications suggestive for thrombophilia in the past and present pregnancies. Results: The study of the anamnesis of the past pregnancies revealed a generally bigger number of obstetrical complications in the group of women with varicose veins. Statistically significant data was obtained for the incidence of stagnated pregnancy, found 7 times more often (10% of women from the main group vs 1,4% women from the control group, t=2,2333, p<0.05) and preeclampsia, found 5 times more often (15.7% versus 2.9%, t=2.2333, p<0.05) in women with varicose veins. During the current pregnancy, these women developed the following disorders more frecvently: hipertensive pregnacy disorder- 3 times more often (17,1% versus 5,7%, t=2.8822, p<0.01), and 5 times more often venous thrombosis (15,7% versus 2,9%, t=2,2333, p<0.05) and intrauterine gowth restriction (20,0% versus 4,3% , t=2.9288, p<0.01). Also, in the control group we weren’t able to identificate cases of pulmonary thromboembolism and abruptio placentae. When we evaluated the risks of developing complications, we found out that in the main group women had a 3,41 fold higher risk to have a hipertensive pregnacy disorder (OR=3,41, CI 95,0%: 1,043-11,169, p<0,01, AR%=70,7), a 6,34 fold higher risk to develop venous thrombosis (OR=6,34, CI 95,0%: 1,35-29,761, p<0,01; AR%=84.2), a 5,58 fold higher risk for intrauterine gowth restriction (OR=5,58, CI 95,0%: 1,527-20,415, p<0,01; AR%=82.1), a 7,7 fold higher risk for stagnated pregnancy ( OR=7,7, CI 95,0%: 1,118-24,061, p<0,01); AR%=87.0) and a 6,34 fold higher risk for preeclampsia (OR=6,34, CI 95,0%: 1,35-29,761, p<0,01; RA%=84.2). Conslusions: During pregnancy, women with varicose veins are more prone to develop thrombophilia associated complications. This leads us to the idea of using the presence of the varicose veins as an early indicator/ surrogate marker of a possible thrombophilic disorder, helping us to establish the diagnosis, begin prophylaxis or adequate treatment faster. |
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Cuvinte-cheie thrombophilia, pregnancy complications, varicose veins |
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