Changes in lower extremity blood flow during advancing phases of pregnancy and the effects of special footwear
Mudanças no fluxo sanguíneo das extremidades inferiores nas fases avançadas da gravidez e os efeitos de calçado especial
Marta Gimunová, Martin Zvonař, Kateřina Kolářová, Zdeněk Janík, Ondřej Mikeska, Radek Musil, Pavel Ventruba, Peter Šagat
Abstract
Background: During pregnancy, a number of changes affecting venous blood flow occur in the circulatory system, such as reduced vein wall tension or increased exposure to collagen fibers. These factors may cause blood stagnation, swelling of the legs, or endothelial damage and consequently lead to development of venous disease. Objectives: The aim of this study is to evaluate the effect of special footwear designed to improve blood circulation in the feet on venous blood flow changes observed during advancing phases of pregnancy. Methods: Thirty healthy pregnant women participated in this study at 25, 30, and 35 weeks of gestation. Participants were allocated at random to an experimental group (n = 15) which was provided with the special footwear, or a control group (n = 15). At each data collection session, Doppler measurements of peak systolic blood flow velocity and cross-sectional area of the right popliteal vein were performed using a MySonoU6 ultrasound machine with a linear transducer (Samsung Medison). The differences were compared using Cohen’s d test to calculate effect size. Results: With advancing phases of pregnancy, peak systolic velocity in the popliteal vein decreased significantly in the control group, whereas it increased significantly in the experimental group. No significant change in cross-sectional area was observed in any of the groups. Conclusions: Findings in the experimental group demonstrated that wearing the footwear tested may prevent venous blood velocity from reducing during advanced phases of pregnancy. Nevertheless, there is a need for further investigation of the beneficial effect on venous flow of the footwear tested and its application.
Keywords
Resumo
Contexto: Durante a gravidez, uma série de mudanças que afetam o fluxo venoso ocorrem no sistema circulatório, tais como menor tensão da parede venosa ou aumento da exposição a fibras de colágeno. Esses fatores podem causar estagnação sanguínea, inchaço das pernas ou dano endotelial e, consequentemente, levar ao desenvolvimento de doença venosa. Objetivos: O objetivo deste estudo foi avaliar o efeito do uso de calçados especiais projetados para melhorar a circulação sanguínea dos pés sobre as mudanças no fluxo venoso observadas nas fases avançadas da gravidez. Métodos: Trinta gestantes saudáveis participaram deste estudo às 25, 30 e 35 semanas de gestação. As participantes foram aleatoriamente designadas a um grupo experimental (n = 15) que recebeu calçados especiais, ou um grupo controle (n = 15). A cada sessão de coleta de dados, foram obtidas medidas Doppler do pico de velocidade do fluxo sanguíneo sistólico e da área transversal da veia poplítea direita, utilizando-se um aparelho de ultrassom MySonoU6 com transdutor linear (Samsung Medison). As diferenças foram comparadas utilizando-se o teste d de Cohen para calcular o tamanho do efeito. Resultados: Nas fases avançadas da gravidez, o pico da velocidade sistólica na veia poplítea diminuiu significativamente no grupo controle, porém aumentou significativamente no grupo experimental. Não houve mudanças significativas na área transversal da veia poplítea em nenhum dos grupos. Conclusões: Os achados do grupo experimental demonstraram que o uso dos calçados especiais testados pode evitar que a velocidade do fluxo venoso diminua nas fases avançadas da gravidez. No entanto, mais estudos são necessários para investigar os efeitos benéficos sobre o fluxo venoso do uso dos calçados testados e suas aplicações.
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