Varicose Veins in Pregnancy
Why are varicose veins common in pregnancy?
Varicose veins are more common in pregnant women and become more prominent during the second trimester. The etiology is not fully understood however it is believed that the venous changes associated with pregnancy occur as a result of hormonal changes and increased pressure on large veins in the lower abdomen with subsequent venous distention caused by enlarged uterus usually by the third trimester. A negative effect of increased progesterone levels along with increased volume of blood in the circulation of pregnant women predispose to a weak vein walls and valves, and may accelerate sudden formation of varicose veins or spider veins.
Where can varicose veins develop during pregnancy?
More than 40 percent of pregnant women experience problems with varicose veins. They commonly occur on the legs and thighs but during late pregnancy, varicose veins may develop near the vulva, labia or vagina. If a female has varicose veins of the vulva during pregnancy, usually varicosities of the legs occur at the same time.
Do varicose veins get worse during pregnancy?
Pregnancy induced varicose veins can become progressively worse during gestation however may regress after delivery. For instance varicose veins on the vulva or vagina do get better once the baby has been delivered The appearance and symptoms are usually greatly improved within six weeks of delivery, though varicose veins are less likely to disappear completely if you had them before pregnancy, have a family history of varicose, stand for long periods of time or are overweight. Unfortunately, majority of women who do develop varicose veins of the leg will retain these varicosities after pregnancy. They start to become more prominent and dilated usually becoming symptomatic and affecting activities of daily living. It is very unlikely that these varicosities will spontaneously resolve without any treatment.
Who is more predisposed to develop varicose veins during pregnancy?
If you are overweight or stand on your feet for long periods of time while pregnant, you are more susceptible to varicose veins. This is partly due to the added pressure on your uterus and the added blood in your circulation system. You are also more susceptible if you have family member of varicose veins. Approximately 30% percent of women without a prior problem with varicose veins will develop them in pregnancy. Varicose veins are more common in females and this has been linked to the sex hormone, estrogen. In pregnancy, varicose veins have been linked to excess weight gain and fluids. Multiple pregnancies are also associated with varicose veins and old moms are more prone to develop them. In fact, with multiple pregnancies, the varicosities always worsen in size, shape and also symptoms.
What are symptoms of varicose veins in pregnancy?
Apart from being very unsightly varicose veins can be painful, tender and cause the legs to swell up during the day. The legs may feel heavy, tired particularly towards the end of the day.
What can I do about my varicose veins while I am pregnant?
Unfortunately there is no cure for varicose veins but preventive measures can be taken to delay the worsening of existing varicose veins. For those with varicosities of the legs, conservative treatment should be followed until the pregnancy is over. This will require daily wearing of prescription grade graduated compression pantyhose that are fitted to the pregnant patient after measurements are taken and legs elevation whenever possible. You should seek medical advice if you are unsure which is most effective. The stockings should be applied before rising from bed in the mornings and only be removed when going to bed at night.
The below tips may help to prevent varicose veins from forming if implemented early in pregnancy:
- Lead active lifestyle with exercises or brisk walking (stimulation of calf muscle pump).
- Keep legs elevated while long sitting or sleeping, as it gives your veins a break and releases the pressure that is on them.
- Lie on your left side keeping your legs elevated. This prevents the fetus from pressing on the leg veins and decreases the chance of developing varicosities.
- Avoid standing for prolonged periods.
- Don't cross your legs when sitting down.
- Wear elastic stockings when long sitting or standing.
- Maintain healthy weight as varicose veins are more common in obese individuals.
- Avoid tight clothing that can compress the waist or groin.
- Eat a low-salt diet as salt does retain water causing your legs to swell up.
What complications can I expect if varicose veins are left untreated?
Varicose veins in pregnant women usually worsen with each pregnancy, as do the symptoms of pain, throbbing, heaviness, tiredness and itching of the leg. Pregnant women have a higher risk of deep vein thrombosis or pulmonary embolism due to abnormal clotting, reduced blood flow and damage to the veins that may lead to serious and even life-threatening conditions. Women who are obese, older than 35, or have personal or family history are more prone to develop blood clots. After delivery the risk is higher than during pregnancy and returns to normal after a few weeks after delivery. During pregnancy women with prominent and enlarged superficial veins can develop superficial phlebitis, a condition where a clot is present in the vein, the varicose veins are inflamed and tender, and the overlying skin becomes red.
It is different to and much less serious than deep venous thrombosis. Varicose veins may also be associated with bleeding, and due to high blood pressure in the venous system, the bleeding can be profuse. At rare cases venous ulcers, predominantly at the ankle site, may form when the veins do not drain properly, high blood pressure builds up, damaging the skin which then breaks down into an ulcer. Venous eczema may be present due to the leakage of small amount of blood from the veins into the skin causing redness, dryness and itchiness. If you develop any of these complications during pregnancy you should seek urgent medical advice from you vein expert. Most people with varicose veins however do not develop complications. The size of the varicose vein is not related to complications but the duration of the varicose vein is.
What kind of treatment should I seek for my varicose veins?
If a woman has varicose veins and desires to have children, she would be advised to have the varicose veins treated first with use of cutting-edge minimally invasive techniques before getting pregnant. If a woman with varicose veins finds herself pregnant, she should begin daily wearing the compression pantyhose plus take adequate preventive measures as soon as possible. If varicose veins first develop with a pregnancy, conservative therapy, which includes daily use of compression stockings, exercise, and legs elevation whenever possible, should be followed. Then the varicose vein problem should be addressed between pregnancies to avoid future difficulties and complications.
At Dr.Mrek Sepiolo’s Vein Centre and Clinics you can assured bespoke treatment for varicose veins associated with pregnancy is offered. The scope of expert services ranges from spider veins to leg varicose veins to vulval and labial varicose veins.