Our Experience of Planned Surgical Treatment of Some Forms of Primary Chronic Vein Disease During Pregnancy
Introduction. The authors assessed the clinical efficacy and safety of the planned open surgical treatment of primary symptomatic chronic venous disease in the C2s4s, Ep, As, p, Pr saphenous and/or non-saphenous veins pool (according to CEAP 2004 classification) in the 2nd3rd trimesters of pregnancy. Purpose. To study the results of open planned surgical treatment of PSCVD of the pool of safenous and / or non-safenous veins in pregnant women and its effect on the pregnant woman and the fetus during surgery and in the postoperative period Materials and methods. The study included 457 pregnant women, who were operated on as it was planned. In all operated patients, there was used the monitoring protocol for patients with chronic venous disease, developed by the authors, which is based on the following: a multidisciplinary approach to managing patients in the amount, which depends on the stage of obstetric care for mother and child, with hospitalization in the specialized obstetric hospital for routine open individual surgery performed under tumescent anesthesia by a vascular surgeon, the so-called mono-technologist, obstetric vascular surgeon in the optimal period of pregnancy (2838 weeks) perinatal psychotherapeutic preparation of the pregnant woman and the fetus at all stages of observation. Results and discussion. The results of the study showed that due to the use of the protocol, 97.2 of operated patients received a positive clinical effect of surgical treatment with 100 absence of all complications in the fetus and mother. In 98 of the operated patients, there took place comfortable pregnancy in the postoperative period, reduction of hospitalization period, and quick return to normal life. All operated patients did not require pharmacological support in the postoperative and postpartum periods, except for using the stretch fabric of the 1st2nd compression class (stockings or knee socks) during exercise. Conclusion. The authors objectively proved the effectiveness of the Protocol for patients, who underwent open planned surgery with the first symptom of chronic vein congestion. There was emphasized the need for further research on the wider introduction of planned surgical treatment of the first symptom of chronic vein congestion during pregnancy in the work of specialized obstetric institutions.