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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Chronic Venous Disease in Pregnancy: Pathophysiology, Diagnostic Pitfalls, and a Trimester-Stratified Management Framework—A Narrative Review

  • Raluca Stefana Stan (Bran)1,2
  • Iustina Petra Solomon Condriuc1,3
  • Raluca Maria Haba1,3
  • Vasile Adrian Sescu1,3
  • Raluca Anamaria Mogos1,3
  • Claudia Florida Costea1,4,5
  • Alexandru Carauleanu1,3
5 affiliations
  1. 1Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
  2. 2Surgical Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
  3. 3Department of Obstetrics and Gynecology, Cuza Voda Hospital, 700038 Iasi, Romania
  4. 4Department of Ophthalmology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
  5. 5Department of Ophthalmology, Prof. Dr. Nicolae Oblu Emergency Clinical Hospital, 700309 Iasi, Romania
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Abstract

Chronic venous disease (CVD) in pregnancy is common, poorly codified, and interpreted with diagnostic thresholds, severity instruments and treatment algorithms all derived outside pregnancy. This narrative review synthesises the mechanistic, epidemiological, diagnostic and therapeutic literature, keeping pregnancy-specific evidence separate from evidence extrapolated from non-pregnant populations. Gestational change is characterised principally by increased venous capacitance and vein-wall distension; ambulatory venous hypertension was not demonstrated in the two pregnancy studies assessing it; and new reflux develops in a minority, undetectable postpartum in the one study reporting it. Physiological adaptation, CVD and thrombotic pathology overlap clinically, deep vein thrombosis and superficial vein thrombosis being at once the principal differential diagnoses and potential complications. Management is correspondingly conservative: compression relieves symptoms but has not been shown to prevent varicose veins, routine initiation of venoactive drugs is not supported, and intervention is deferred other than in exceptional circumstances. A venous finding first detected in pregnancy warrants postpartum reassessment before it is taken for established disease. A trimester-stratified framework spanning preconception to late postpartum reassessment is proposed; it is evidence-informed rather than prospectively validated, and is not a guideline.

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Cite

BibTeXRIS
BibTeX
@article{bran2026chronic,
  title = {{Chronic Venous Disease in Pregnancy: Pathophysiology, Diagnostic Pitfalls, and a Trimester-Stratified Management Framework—A Narrative Review}},
  author = {Raluca Stefana Stan (Bran) and Iustina Petra Solomon Condriuc and Raluca Maria Haba and Vasile Adrian Sescu and Raluca Anamaria Mogos and Claudia Florida Costea and Alexandru Carauleanu},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15208111},
  url = {https://www.mdpi.com/2077-0383/15/20/8111},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Chronic Venous Disease in Pregnancy: Pathophysiology, Diagnostic Pitfalls, and a Trimester-Stratified Management Framework—A Narrative Review
AU  - Raluca Stefana Stan (Bran)
AU  - Iustina Petra Solomon Condriuc
AU  - Raluca Maria Haba
AU  - Vasile Adrian Sescu
AU  - Raluca Anamaria Mogos
AU  - Claudia Florida Costea
AU  - Alexandru Carauleanu
PY  - 2026
DA  - 2026/10/01
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15208111
UR  - https://www.mdpi.com/2077-0383/15/20/8111
AB  - Chronic venous disease (CVD) in pregnancy is common, poorly codified, and interpreted with diagnostic thresholds, severity instruments and treatment algorithms all derived outside pregnancy. This narrative review synthesises the mechanistic, epidemiological, diagnostic and therapeutic literature, keeping pregnancy-specific evidence separate from evidence extrapolated from non-pregnant populations. Gestational change is characterised principally by increased venous capacitance and vein-wall distension; ambulatory venous hypertension was not demonstrated in the two pregnancy studies assessing it; and new reflux develops in a minority, undetectable postpartum in the one study reporting it. Physiological adaptation, CVD and thrombotic pathology overlap clinically, deep vein thrombosis and superficial vein thrombosis being at once the principal differential diagnoses and potential complications. Management is correspondingly conservative: compression relieves symptoms but has not been shown to prevent varicose veins, routine initiation of venoactive drugs is not supported, and intervention is deferred other than in exceptional circumstances. A venous finding first detected in pregnancy warrants postpartum reassessment before it is taken for established disease. A trimester-stratified framework spanning preconception to late postpartum reassessment is proposed; it is evidence-informed rather than prospectively validated, and is not a guideline.
SN  - 2077-0383
ER  -