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Venöse Insuffizienz in der Schwangerschaft

Venous insufficiency during pregnancy

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Zusammenfassung

Schwangerschaft und Geburt gehen mit einer erhöhten Rate an venösen Erkrankungen einher. Bereits in der ersten Schwangerschaft kommt es bei 34%, in der zweiten bei 60% und ab der dritten bei 70% der Frauen zur Ausbildung einer Varikosis. Die Veränderungen, die der venösen Insuffizienz zugrunde liegen, bestehen aus der „Trias“ von venöser Dilatation, Klappeninsuffizienz und venöser Hypertension. Die schwangerschaftsbedingten Ursachen beinhalten zum einen anatomische Ursachen, wie die geänderte Lage des Uterus, als auch endokrine Faktoren, wie den Einfluss der hormonellen Umstellungen auf den Tonus der Gefäßmuskulatur. Sowohl für Varizen als auch für Hämorrhoiden sollte 6–12 Monate nach der Geburt eine Reevaluierung erfolgen, um ein stadiengerechtes therapeutisches Vorgehen einzuleiten.

Abstract

Pregnancy and childbirth are associated with an increased rate of venous diseases. During their first pregnancy, up to 34% of women will have signs of varicosities, 60% during the second and up to 70% during the third pregnancy. Venous dilatation, valvular incompetence and venous hypertension are representing the pathophysiologic mechanisms which are important factors to develop venous insufficiency. Mechanical compression of enlarged uterus on pelvic veins and hormonal changes are involved in the pathophysiologic mechanisms. However reevaluation and stage-related indication for surgical intervention should follow 6 to 12 months after delivery.

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Authors and Affiliations

  1. Klinik für Gefäßchirurgie und Nierentransplantation, Heinrich-Heine-Universität Düsseldorf

    M. Pillny, H. Kretschmer & G. Möslein

  2. Klinik für Gefäßchirurgie und Nierentransplantation, Heinrich-Heine-Universität, Moorenstraße 5, 40225, Düsseldorf

    M. Pillny

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  1. M. Pillny
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Correspondence to M. Pillny.

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Pillny, M., Kretschmer, H. & Möslein, G. Venöse Insuffizienz in der Schwangerschaft. Gynäkologe 38, 613–618 (2005). https://doi.org/10.1007/s00129-005-1710-4

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