SURGICAL MANAGEMENT OF VARICOSE VEINS IN WOMEN WITH CHRONIC VENOUS INSUFFICIENCY DURING PREGNANCY: OBSTETRIC AND VASCULAR PERSPECTIVE

Abstract

Introduction: The surgical approach to varicose veins in pregnant women with chronic venous insufficiency is a complex issue that involves both obstetric and vascular considerations. During pregnancy, hormonal changes and increased venous pressure contribute to the exacerbation of venous symptoms, leading many women to seek interventions. Chronic venous insufficiency can result in significant discomfort, compromising quality of life and, in some cases, affecting fetal health. Surgical options, including phlebectomy and ablation, raise questions about safety and efficacy when performed in a gestational context, requiring careful consideration of the risks and benefits for mother and baby. Objective: To analyze recent studies on the surgical approach to varicose veins in women with chronic venous insufficiency during pregnancy, considering obstetric and vascular aspects. Methodology: The research was performed using the PRISMA checklist, with searches in the PubMed, Scielo and Web of Science databases. Five descriptors were used: "varicose veins", "chronic venous insufficiency", "pregnancy", "surgery", and "vascular health". Inclusion criteria included articles published in the last 10 years, studies that addressed varicose vein surgery in pregnant women, and research that included obstetric and vascular outcomes. Exclusion criteria included non-systematic reviews, articles that did not focus on the pregnant population, and studies that did not present relevant data on surgical outcomes. Results: The review revealed that, although varicose vein surgery during pregnancy can be performed safely in selected cases, it is essential to consider the gestational stage and severity of symptoms. Most studies indicated a high success rate in reducing symptoms and preventing complications, such as deep vein thrombosis. However, potential risks, including anesthetic complications and adverse effects on pregnancy, required careful evaluation by the medical team. Conclusion: Surgical treatment of varicose veins in pregnant women with chronic venous insufficiency has proven to be an intervention that can be beneficial in certain situations, provided it is performed by experienced professionals. Analysis of the available data highlighted the importance of a multidisciplinary approach, considering both the health of the mother and the fetus.