From venous congestion to placental hypoxia: the underappreciated role of chronic venous disease in impaired placenta development and pregnancy health

Chronic Venous Disease (CVD) is a common vascular disorder, primarily affecting the lower extremities, with a significantly higher incidence in women. Pregnant women represent a particularly high-risk population for CVD. Early screening and assessment of CVD severity and progression during pregnancy are imperative for preventing Venous Thromboembolism (VTE). Despite its high prevalence, CVD in pregnancy often remains underestimated, frequently being managed by clinicians as a localized and benign condition. However, emerging evidence suggests that CVD may exert broader systemic effects, potentially compromising placental development and fetal well-being through alterations in the maternal-placental-fetal circulation. Nevertheless, the precise correlations between CVD and a spectrum of adverse pregnancy outcomes remain unclear. Also, the standardized management strategies for CVD in pregnancies are yet to be established. This review synthesizes current literature to delineate the present understanding and identify persistent knowledge gaps in this field. Furthermore, it aims to underscore the clinical significance of CVD in pregnancy and to propose pertinent directions for future research, thereby advocating for heightened clinical awareness and more investigative efforts.