Compression therapy during pregnancy: bane or boon?

Background: During pregnancy, various factors cause the development of peripheral oedema in the lower limb. In addition, pregnancy is a risk factor for the development of varicose veins and thromboembolic events. Prophylactic provision of pregnant women with compression hosiery is often only performed in risk situations, but not as standard treatment. The aim of the study was to investigate the effect of an optimally adjusted compression therapy with regard to the reduction in oedema and subjective symptoms during pregnancy. Patients and methods: In a randomised, prospective study, 21 pregnant women (33.4 years of age [SD 4.4 years]) in the clinical stages C0 (3), C1 (11), C2 (6) and C3 (1) were investigated. 13 women were supplied with a compression pantyhose, 8 women had no compression. At 4-weekly intervals, the patients’ leg circumference and leg volume were measured using water plethysmography and non-contact Image 3D. In parallel to this, the women’s quality of life and subjective symptoms were evaluated using patient questionnaires. Digital photoplethysmography, Doppler and duplex ultrasound examination of the leg veins were conducted at the beginning of the study, shortly before delivery and 3 months postpartum. Results: In both groups, a growing leg volume increase occurred linear with the increase in body weight during the pregnancy. However, water plethysmography showed a much smaller increase in lower leg volume in the patient group with compression hosiery (p<0.05). At the beginning of the study, the quality of life and the subjective symptoms had been rated as worse in the group with compression hosiery than in the group without it. During the course of pregnancy, however, an improvement occurred rather than any exacerbation. The negative characteristics of wearing the compression hosiery were rated as negligible, which was reflected in the high compliance with regard to the length of time the hosiery was worn. Conclusion: Compression therapy in pregnant women is well tolerated and counteracts the pregnancy-induced increase in lower leg volume and should therefore be included in the general health care recommendation for pregnant women.