Venous circulation in the maternal lower limb: a Doppler study with the Valsalva maneuver

In order to evaluate the normal physiology of the maternal venous circulation, Doppler examinations of the venous system in the right inferior extremity and suprainguinal part of the common femoral vein were carried out in 38 healthy pregnant women, in 12 non-pregnant controls and in 16 women at early puerperium. Examinations were carried out when the mother was lying in a left semi-recumbent supine position. Blood flow velocities in the suprainguinal femoral and deep femoral veins decreased significantly in the first trimester and were almost normalized by the third postpartum day. Continuous forward venous flow with respiratory fluctuation was maintained in the femoral veins over the whole gestational period. The response to the Valsalva maneuver was similar in the pregnant and non-pregnant women. Our findings provide evidence that the venous valvular system and wall distensibility in the femoral area and the inferior extremity are in vivo not greatly changed in pregnancy. A more important reason for decreased velocities is probably the pregnancy-associated decrease of the arterial input to this area.