Effect of pregnancy on the accuracy of light-reflection rheography.
Light-reflection rheography is a noninvasive method to detect venous obstruction by indirectly measuring venous emptying time. In nonpregnant women it has greater than 90% sensitivity when compared with venography but has not been tested during gestation. To determine if the nonthrombotic occlusion of venous outflow by the pregnant uterus might alter the performance of light-reflection rheography, we examined 17 normal patients with a vascular Accuscan (Hemodynamics, Inc., Boca Raton, Fla.) in the third trimester of pregnancy and 11 patients during the early second trimester. These results were compared with the defined normal (nonpregnant) rate of venous emptying (slope 0.54 +/- 0.06). The mean (+/- SD) for the entire sample was 0.58 +/- 0.23 mm/sec in the right leg and 0.52 +/- 0.19 mm/sec in the left leg measured in the standard sitting position (p = 0.21). The results did not vary with gestational age. A subset of patients in late pregnancy were used to compare the effect of various positions (supine, lateral decubitus, and sitting) on test performance. Positions other than sitting provided results that were inconsistent. It appears that the large pregnant uterus does not significantly obstruct venous outflow from the lower extremities in the standard sitting position; thus the results of light-reflection rheography are not affected. Comparison of light-reflection rheography versus venography in pregnant patients with suspected venous thrombosis is being investigated.
Allbert
J R
JR
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson 39216-4505.
Roberts
W E
WE
Hess
L W
LW
Morrison
J C
JC
D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply*; D010992:Plethysmography, Impedance / Q000379:methods*; D011187:Posture / Q000502:physiology; D011247:Pregnancy / Q000502:physiology*; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D012039:Regional Blood Flow; D014599:Uterus / Q000502:physiology*