Comparative Assessment of the Quality of Life of Patients with Combined Primary Symptomatic Varicose Veins of the Lower Extremities, Inguinal Canal and Perineum During Pregnancy, Depending on the Methods of Treatment

Chronic venous disease today is a common form of pathology among patients with cardiovascular diseases, especially in pregnant women. Solving the issue of maintaining the quality of life of women during pregnancy with venous pathology is a problem of today, which is especially relevant and not fully resolved. Purpose To conduct a comparative assessment of the quality of life of patients with combined primary symptomatic varicose veins of the lower extremities, inguinal canal and perineum during pregnancy, depending on the methods of treatment. Materials and Methods of Research The dynamics of quality of life from the method of treatment of combined primary symptomatic varicose veins of the lower extremities, perineum, inguinal canal during the gestational period were analyzed in 85 pregnant women. To assess the quality of life before and after treatment, the CIVIQ-20 questionnaire was used. The severity of the course of chronic vein disease was studied using the VCSS scale. deep), inguinal canal and perineum before and after treatment. Results and Discussion Pregnant women were divided into 3 groups depending on the method of treatment. Patients of the first group consisting of 25 (29.41%) pregnant women, 5 of whom completely refused treatment for one reason or another, 20 received treatment irregularly, not in full. Pregnant women of the second group consisting of 30 (35.29%) patients received conservative treatment in combination with compression therapy. The third group, 30 (35.29%) patients who agreed to open surgery, which was supplemented with compression therapy as needed. Treatment was carried out in 70.59% of patients in the 11- 111th trimesters of pregnancy in the volume according to indications, depending on the trimester also at the request of patients. The main reason for seeking medical help, according to patients, was the deterioration in the quality of life. It was noted that there is a difference among the three groups of dynamics of the quality of life of patients, depending on the method of treatment. The most rapid, pronounced and stable improvement in the quality of life throughout pregnancy in all its parameters, according to patients, was recorded in 98.2% of pregnant women of the third group. In the second group, among 30 pregnant women, 45.3% of patients had an improvement in the quality of life, but 32.9% of pregnant women in this group had an unstable course in the direction of deterioration in the quality of life of patients during pregnancy, especially in the third trimester. In all 28 pregnant women of the first group, a deterioration in the quality of life relative to the initial period was recorded throughout the gestational period. Analyzing the effect of treatment methods on the quality of life and severity of chronic vein disease of pregnant women suffering from combined primary symptomatic progressive varicose veins of the lower extremities, perineum and inguinal canal, external genital organs, we came to the conclusion that qualitatively performed, according to patients, open surgical treatment of this pathology is the most effective and long-lasting in terms of positive results both during pregnancy and in the postpartum period. Thus, in the third group, quality of life indicators improved by 42.85% and the severity of chronic venous disease decreased by 69.59%. As for conservative treatment in the second group of patients, according to their subjective assessment, according to the CIVIQ-20 questionnaire and the VCSS scale, there was an improvement in quality of life indicators by 6.68%, respectively, and a decrease in the severity of chronic venous disease by 17.6%. Among 25 patients of the first group, there was a decrease in the deterioration of quality of life and severity of chronic venous disease by 3.2% and 33.63%, respectively Conclusions Combined primary symptomatic progressive chronic varicose veins of the lower extremities, perineum, external genital organs of the inguinal canal refers to diseases with a progressive course that affect the course of pregnancy and quality of life. The use of the CIVIQ-20 questionnaire and the VCSS disease clinical severity scale to study the effect on quality of life in pregnant women is as specific as possible for patients with chronic venous disease. Adequate comprehensive treatment of patients of the third group, including open mini-surgical intervention in a planned manner with the consent of pregnant women with the simultaneous elimination of sources of pathological venous reflux (vertical and / or horizontal), with the removal of varicose conglomerates according to indications on the thigh and / or lower leg, leads to an improvement in quality of life by 42.85% and alleviates the severity of chronic venous disease by 69.59% Traditional conservative complex treatment, including the use of phlebotropic drugs (local and/or combined use if necessary) with compression therapy (compression class 2) according to the CIVIQ-20 questionnaire and the VCSS scale, an improvement of these indicators was noted by 6.68% and 17.6%, respectively The results of the quality of life study carry valuable additional information about the role of treatments for chronic venous insufficiency, which allows for improved understanding between the doctor and the patient in achieving the best treatment results.