Varicose veins in pregnancy - causes, symptoms, prevention and treatments

Varicose veins on the legs during pregnancy occur even in 40-50% ladies who are expecting a baby. Although they are used to be considered a fairly common affliction, it is a mistake to assume that this is a normal thing to be put up with. If you take proper care of your legs, you stand a good chance of preventing unpleasant problems in the future.

Varicose veins being a symptom of venous insufficiency, are dilated, tortuous vessels usually visible just under the skin. They look like bulges and are usually purple-blue in colour.

Varicose veins of the lower limbs during pregnancy is a common problem especially in those women who have an anatomical inclination usually located in the small pelvis or abdominal cavity (more on the VENOUS PRESSURE PHENOMENA and PELVIC VENOUS INSUFFICIENCY can be found at Clinics of Phlebology)

The genetic background for the occurrence of varicose veins is related to the hereditary tendency of the vein walls to stretch. This tendency is most pronounced during pregnancy due to high levels of female sex hormones and overloading of the venous system with increased circulating blood.

Causes of varicose veins in pregnancy

During pregnancy, there is an increase in pelvic tightness in the small pelvis, later moving into the abdominal cavity as well.

The enlarging uterus and with it the foetus compress the venous bed, especially the iliac veins and the inferior vena cava. Depending on anatomical conditions and the action of the hormones themselves (mainly oestrogen), ovarian vein dilatation and the formation of varicose veins of the parametria occur. 

These phenomena lead to an increase in pressure in the venous system. The veins in the legs are most affected by this, due to their location. This leads to varicose veins, not only in the legs, but also in the small pelvis, perineum and vulva in women [photo below shows vulvar varices in MR venography].

If, in addition, a woman sits a lot while pregnant and her activity level is low, the venous vessels are additionally overloaded and the condition of the veins deteriorates.

Symptoms of venous insufficiency - how do you recognise if you are affected?

A harbinger of varicose veins in pregnancy can be the appearance of spider veins, which are reddened networks of blood vessels on the legs that are visible to the naked eye. In addition symptoms of varicose veins are quite characteristic. Typical are recurrent swelling of the calves and a feeling of heavy legs. Sometimes you may also feel pulsation in your legs and, in more advanced stages, itching, burning and intense pain around the strained veins. Varicose veins, as mentioned, give visual symptoms. There are bulges on the legs and dark blue or purple blood vessels clearly outlined under the skin, which can sometimes take the form of a purple stripe. It is important to remember that varicose veins are not just an aesthetic defect. They are one of the symptoms (stages) of venous insufficiency of the lower limbs, leading in some cases to skin discolouration, wounds on the legs (venous ulcers) or thrombophlebitis. Varicose veins also increase (up to three times) the risk of venous thrombosis in the deep venous system. For this reason, it is worth doing everything possible to prevent their formation and, if they have already started to form, not to let them develop.

Venous insufficiency prevention and treatment options - how to manage this condition?

As always, education and prevention are most important. Since varicose veins of the lower limbs during pregnancy is a common condition, women tend to ignore and downplay it. Sometimes it is only the final aesthetic defect that prompts them to seek answers: what for varicose veins? It is important to be aware of possible complications and unpleasant, painful symptoms and to take good care of your legs after pregnancy. According to doctors' recommendations, from the 3rd month of pregnancy, every woman, whether or not she has had previous problems with varicose veins, should wear special compression stockings.

Their selection is not straightforward, so in order to choose the right product, it is necessary to consult the doctor of phlebologyYou should seek the advice of a specialist who has the necessary experience to take your measurements and advise you on the best product for you. Remember to repeat these measurements, preferably in your 3rd trimester of pregnancy, as the circumference of your legs may change due to weight gain and increased water retention in your body.

Usually women are surprised to learn that it is not advisable to stop wearing compression products once the baby is in the world. It is also a good idea to use them during childbirth and the postpartum period, when the legs are particularly stressed and hormones are running wild, so the elasticity of the veins may be reduced. Compression stockings not only prevent the formation of new varicose veins, but also slow down the widening of those that have previously occurred. Importantly, they also reduce the risk of venous thrombosis!

If you notice that varicose veins have appeared on your legs during pregnancy, see a reputable phlebologist for a consultation. He or she may recommend a venous Doppler ultrasound, a non-invasive test to assess the condition of your blood vessels and to guide you towards appropriate treatment, which can be started around three months after delivery.

Awareness of the problem in venous insufficiency is very important, and treating it as early as possible and taking proper preventive action is even key. Remember exercises to improve muscles during pregnancy (without lifting) and appropriate gels relieving the symptoms of varicose veinsmay be an additional part of the treatment, but nothing can replace well-chosen compression products and consultation with an experienced specialist. phlebologist!

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