Varicose veins during pregnancy

According to obstetricians and gynecologists, varicose veins during pregnancy are noted in 55% of women bearing a child. Violation of the venous circulation worries expectant mothers and raises many questions.

We will try to answer them, but our today's conversation will be devoted to varicose veins on the legs, since the detailed material "Varicose veins of the vagina and external genitalia in pregnant women" has already been published on our portal (you can click on the link).

Causes of varicose veins during pregnancy

Doctors explain the causes of varicose veins during pregnancy with a genetic predisposition to weakening the veins of the veins or the lack of venous valves, as well as the physiological state of the female body in this period.

Ascending venous blood flow from the lower limbs - in defiance of the force of gravity - is provided by contractions of the muscles acting on the walls of the veins (the so-called muscular venous pump), and by venous valves, whose function is to prevent reverse blood flow. With weakness of the venous walls, the vessels are stretched, the lumen of the vessels widens, and the valves can not completely cover them. This leads to an increase in blood pressure in the veins of the legs, and there is their varicose extension. Therefore, if women in the family suffer from this chronic pathology, a pregnant woman is unlikely to avoid this diagnosis.

But the genetic factor only creates the prerequisites for the manifestation of varicose veins during pregnancy, and the key causes are hormonal restructuring and some systemic changes characteristic of this condition. First, the hematopoiesis system in pregnant women works to increase the volume of blood in the vessels. This is the so-called physiologically conditioned, that is, necessary for the normal development of pregnancy, hypervolemia. As a result, by the end of the gestational period the volume of circulating blood increases by 32-35%. And, of course, this increases the pressure on the blood vessels - especially on the veins of the legs.

Secondly, the increased levels of progesterone in pregnant women, as well as the hormone relaxin, synthesized by the ovaries and placenta, in the process of preparing the organism for childbirth causes relaxation of not only ligaments of joints and skeletal muscle fibers, but also smooth muscles of blood vessels - including the walls of veins. And here again everything rests on the fact that the venous valves do not cope with their functions.

And, finally, do not forget that the growing fetus and the growing uterus have a constant and gradually increasing pressure on the venous vessels in the pelvic and abdominal cavity.

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Symptoms of varicose veins during pregnancy

The main symptoms of varicose veins during pregnancy are expressed in the fact that the legs quickly get tired when walking or after a short enough stay in a standing position become "heavy". Often by the end of the day, the feet, the ankle joint area swell, and with time the swelling captures the lower leg. Closer to the evening or at night, there may be cramps calf muscles.

Most often, women pay attention to appearing in the lower part of the shin, on the foot (on the rise and closer to the ankle) or on the calves bluish or purple mesh or "stars" under the skin. This is called telangiectasia and is an external manifestation of enlarged lumens of small vessels. It is also possible to scan through the skin of individual small vessels or parts thereof. Such vessels wriggle under the skin with blue veins and often swell and pulsate, protruding above the skin.

In addition, skin itching, burning and aching pain can be felt that are localized along the subcutaneous veins below or above the knee, popliteal, inferior hollow or superficial femoral vein (from the inside of the thigh).

Diagnosis of varicose veins during pregnancy is based on examination of the patient and collection of anamnesis and in most cases does not represent labor. A blood test for platelets, ultrasound of the veins, dopplerography and rheovasography to pregnant women is performed for medical reasons - with suspicion of thrombophlebitis.

Treatment of varicose veins during pregnancy

It is clear that the treatment of varicose veins during pregnancy has limitations. The main method used for pregnant women is compression therapy with elastic bandages and compression knitwear (stocking, golf, tights for pregnant women). Both can be purchased at pharmacies or medical stores - after consulting a phlebologist who will determine the level or class of compression required.

As a rule, with the preventive purpose of pregnant women it is recommended to wear a special jersey of the first compression class (pressure 18-21 mm Hg), and with an obvious varicose expansion - of the 2nd class (22-27 mm Hg).

With the help of compression therapy, it is possible to reduce the diameter of the superficial veins of the lower limbs, increase the intensity of venous blood flow and reduce blood stasis and swelling.

From the exterior of drugs treating varicose veins in pregnancy permissible use in trimesters II and III Venoruton gel and ointment Troxevasin.

Varicose veins that develop during pregnancy often disappear within a few months after birth - when the hormonal background of women stabilizes after all the changes associated with pregnancy. If the vessels on the legs do not normally return for more than half a year, you need to contact a specialist - phlebologist or a vascular surgeon (for sclerotherapy or phlebectomy).

Prevention and prognosis of varicose veins during pregnancy

You can not change genetics or hormone production during pregnancy. However, you can take steps to maintain normal venous blood flow and help prevent or reduce the effects of varicose veins.

The recommended phlebology prevention of varicose veins during pregnancy involves:

• night sleep and daytime rest with raised legs - 30 degrees higher relative to the plane of the location of the heart (just put a solid pillow under the mattress at the feet of your bed);
• for long periods of pregnancy try to sleep on the left side, as this will reduce pressure on the lower vena cava that is on the right side of the body;
• exclusion of prolonged stay in a standing or sitting position (the body position should be changed every 30-40 minutes or do 10-minute breaks);
• It is necessary to sit, not crossing your legs and not tossing your foot on your leg;
• maximum decrease in heel height (no more than 5 cm);
• daily walks on foot, after which you should lie down for a while, lifting your legs for several minutes;
• control of weight gain (excess weight or a significant increase in a short time especially affects the veins);
• reduction of salt intake (to reduce swelling);
• sufficient intake of vitamin C in the body, which is necessary for the synthesis of collagen and elastin, the connective tissue of blood vessels;
• constant wearing of correctly selected treated compression knitwear.

As experts note, the prognosis of varicose veins during pregnancy depends on the degree of development of pathology and individual characteristics of the course of pregnancy and childbirth. So, the hereditary predisposition, repeated pregnancies, multiple pregnancy, severe childbirth, age of 35 and more years at the first pregnancy, obesity, development of superficial thrombophlebitis complicate the situation.

In the presence of dilated veins before pregnancy, the risk increases that varicose veins during pregnancy can lead to the formation of thrombi and the development of postpartum thrombophlebitis of deep veins.