This work is devoted to the issue of reducing the frequency of complications in the postpartum period in patients with varicose veins by identifying new pathogenetic links of the disease, developing and introducing a set of therapeutic and prophylactic measures into the practice. During the study, 80 pregnant women with varicose veins (VV) and 40 pregnant women with intact veins were examined. A clinical and statistical analysis of these women's data was carried out, and VV risk factors were determined: heredity, maldrending, macrosomia of the fetus in the anamnesis, polycystic ovaries, long uncontrolled use of hormonal contraception. While studying the parameters of the hemostasis system in pregnant women with VV, there were changes that indicated hypercoagulability: a decreased number of platelets, an increased platelet aggregation activity, excessive activation of the procoagulant link of the hemostatic system, a decrease in antithrombin III activity, and acceleration of fibrinolysis. In determining the markers of endothelial dysfunction, an increased level of homocysteine and fibronectin in the third trimester of pregnancy was established in pregnant women, which twice exceeded the rate of women with intact veins. In pregnant women with VV, an immune imbalance was observed in the parameters of cellular and humoral immunity, nonspecific protective factors, which confirmed the pathogenetic role of the immune system in the genesis of varicose veins. Modified immune reactivity with a shift towards autoimmune aggression against venous valves with deficiency of various immunity units increases the severity of avalvulation of venous vessels and the degree of venous insufficiency. Blood flow was assessed using dopplerometry of the right and left outer iliac, ovarian and uterine veins, large subcutaneous and femoral veins. Velocity of blood flow (VBF), the diameter of the cross section (DCS), the volumetric blood flow (VBF) and the cross-sectional area (CSA) of the vessels were determined. The diagnostic value of dopplerometry of small pelvic vessels and lower extremities was determined during the work for the detection of dilated veins, determination of blood flow parameters. Assessment of DCS and CSA of blood vessels allowed determining the degree of severity of VV. Violation of VBF in the examined veins was diagnosed in 83 % of women with VV. Researches of the quality of life with background therapy of VV were carried out by studying the condition of patients using the SF-36 questionnaire. The integral indicator of the quality of life was on the background of the proposed complex therapies – 722 points, against the background of symptomatic therapy – 441 points. The usage of the proposed complex therapy of VV, which included venotonic, anticoagulant, immunomodulator and graded elastic compression from 32 to 36 weeks of pregnancy, reduced the clinical manifestations of the disease (functional discomfort, edema, convulsions at night), increased immune status, improved hemostasis and blood flow in the vessels of the small pelvis and lower limbs, and also improved both physical and psychological health, quality of women`s life, and also prevents the progressing of VV, thrombotic and purulent-septic complications.
