Manifestations of chronic venous disease of the pelvis in pregnancy

Abstract

Taylor first described pelvic venous insufficiency in 1949. Pelvic congestion syndrome affects 15-20% of women. Chronic venous disorders affecting pelvic veins and varicose veins developed among uterus, ovaries and hypogastric plexus, including stasis results in congestion and pelvic pain. Pregnancy is a precipitating factor of occurrence, the vulnerability of vessels, based on hemodynamic factor through vascular incompetence, dilatation and retrograde flow. Secondary pelvic congestion syndrome can be caused by genital prolapse, the prolonged use of progestin agents, infections, uterine fibroids, endometriosis and uterine involution postpartum. Imaging methods that can be used for pelvic congestion syndrome diagnosis and follow-up are transvaginal ultrasonography, computer tomography, magnetic resonance, angiography and venography. Various classes of medications have been used over time, but their effect is transitory and their side effects do not allow their long-term use. Minimally invasive venous embolization remains the treatment with the best results. Areas that remain in continuous research are the optimal agencies for embolization, risk factors predictive of pelvic congestion syndrome and the significance of asymptomatic cases of ovarian venous reflux and pelvic varicosities. Without ignoring the multitude of pathologies that can lead to chronic pelvic pain, pelvic congestion must be one of the diagnostic options, considering its incidence among the population and their frequent association. We review in this article the most important studies found in the literature.