In many ways, pregnancy can be a time of phenomenal changes in the female body. As a woman prepares for a baby soon, she may notice some unexpected side effects. These can include thicker hair growth, shine and hardened nails, radiant skin, and an increase in breast size and fullness.
Unfortunately, not all changes in pregnancy are desirable and pleasant. There will be significant weight gain, mood swings, and frequent urination. This is due to the fact that pregnancy is accompanied by profound changes in the female body due to the restructuring of the hormonal background. Veins also undergo significant changes: their tone decreases, the permeability of the walls increases, and blood flow slows down. Varicose veins are one of the diseases that may appear for the first time during pregnancy or begin to actively progress.
WHAT IS VARICOSE DISEASE
The varicose veins of the lower extremities are persistent and irreversible varicose veins that result from large changes in their walls, as well as the insufficiency of their valvular apparatus due to a genetic defect. The main factors in the appearance of varicose veins are the hereditary weakness of the vascular wall. The secondary factors that lead to varicose veins are prolonged stress on the lower extremities.
Statistics show that between 40 and 65% of pregnant women develop varicose veins at least once in their lives. Most obese women suffer from varicose veins during pregnancy.
Although varicose veins are more common on the legs, they can appear in other places. Especially in late pregnancy, tortuous veins may appear on the buttocks, vagina, or vulva. This happens when the lower abdomen and uterus put greater pressure on the veins in these areas.
CAUSES OF VARICOSIS DURING PREGNANCY
As term increases during pregnancy, a number of changes occur that create preconditions for varicose veins.
- First, the uterus, as it grows, puts pressure on the inferior vena cava, the largest vein in the human body. Excessive pressure creates a slowdown in blood flow, which puts stress on the veins in the legs, where more blood pools. This leads to varicose veins during pregnancy on the legs.
- Second, during pregnancy, the woman's body produces more blood to support the developing baby, delivering uninterrupted oxygen and nutrients to the placenta and fetus. Due to the increased load, the veins must work harder to pump carbonated blood back to the heart from the extremities and pelvis. This can lead to insufficiency of the vein valves and blood pooling in the legs, ankles, feet, and other areas.
- Third, an increase in the level of female sex hormones during pregnancy reduces the tone of the smooth muscles in the walls of blood vessels (especially veins). It can also contribute to varicose veins in pregnant women.
VARICOSIS RISK FACTORS DURING PREGNANCY
Varicose veins are considered a disease with a hereditary predisposition. If the mother or grandmother suffered from varicose veins during pregnancy, the risk of the woman developing this disease increases dramatically.
The incidence of varicose veins increases with age, weight gain, and each subsequent pregnancy. If a woman has twins or triplets, the risk of varicose veins on the legs of pregnant women doubles.
Lifestyle and work habits (long hours standing or sitting without moving) can also cause varicose veins.
Symptoms of varicose veins in pregnant women
Some women have slightly swollen, twisted multi-colored veins on their legs, just a cosmetic issue. In others, varicose veins during pregnancy cause unpleasant symptoms: swelling, pain, or severe discomfort in the legs. In all women with varicose veins on the legs, this is a key sign of varicose veins. If left untreated, venous damage can lead to serious complications, including blood clots, phlebitis, and trophic ulcers. Also, it increases the risk of a fatal complication, PE (pulmonary embolism).
During pregnancy, you should monitor for signs of varicose veins:
- swelling in the area of the legs and ankles, feet;
- spasms or pain in the thigh or lower leg;
- fatigue, heaviness in the legs;
- restlessness, especially at night, desire to move the legs constantly;
- itching, dry or pale skin on legs, burning sensation;
- convoluted and protruding "stars", larger convoluted veins;
- leg or ankle sores that take a long time to heal or do not heal at all;
- leg pain that goes away when a woman walks or raises her legs.
WILL VARICOSIS BE WORSE DURING PREGNANCY?
Unfortunately, varicose veins often get worse as the pregnancy progresses. As the saphenous veins expand, twist, swell, and become more visible, the woman increasingly notices increased pain and other symptoms (swelling, skin changes, heaviness).
VARICOSIS DURING PREGNANCY: WHAT TO DO
If a woman experiences any symptoms of varicose veins, it is imperative to consult a phlebologist. After conducting a detailed physical examination, carefully evaluating the condition of the feet, ankles, legs and thighs, the doctor will confirm the presence of varicose veins and exclude possible complications (using ultrasound and vascular Doppler measurements). As for varicose veins on the vulva, the obstetrician-gynecologist will notice it during a routine exam.
TREATMENT OF VARICOSIS IN PREGNANT WOMEN
Most of the time, surgical intervention and minimally invasive procedures are not prescribed for the treatment of varicose veins during pregnancy. This is associated with a high risk of complications and relapses. Furthermore, the prescription of drugs (phlebotonics, anti-inflammatories, antiplatelets) is very limited.
There are a number of guidelines that help to safely and relatively effectively treat varicose veins in pregnant women.
- Physical activity with doses. Swimming, walking or other exercises for pregnant women with varicose veins, which involve the muscles of the legs, help increase blood circulation in the veins of the extremities. The phlebologist, together with the obstetrician-gynecologist, will select an individual set of exercises for a specific period and the severity of the pregnant woman's condition.
- Well-fitting footwear. High heels and a completely flat sole interfere with the movement of the leg muscles, making it difficult for venous blood to circulate. You need to choose stable and comfortable shoes with a small heel (3-4 cm).
- Compression shirt. To support the veins during pregnancy, you need to wear a compression garment. The phlebologist will individually select the degree of compression and the type of product: pantyhose, stockings or tights. You should put them on in the morning, without getting out of bed, and take them off at night when the woman goes to bed.
HOW TO RELIEVE VARICOSIS DURING PREGNANCY
There are a number of tips for the prevention of varicose veins in pregnant women, the observance of which helps to alleviate the course of the disease and reduce discomfort:
- Don't cross your legs. Sitting with one leg over the other blocks blood flow through the veins and can cause pressure to build up.
- Change position. If you have to sit or stand all day at work, change your posture as often as possible. This prevents blood from pooling in the legs.
- Sleep on your left side. As your belly enlarges, it will be difficult for you to lie on your back. For varicose veins, try to sleep on your left side, not your right. This prevents pressure from the uterus on the veins in the abdominal cavity and helps blood flow from the lower extremities at night.
- Raise your legs. Raise your legs more often throughout the day. Ideally, they should be above the level of the heart so that the force of gravity helps the blood flow more actively. While lying in bed, you can prop your feet on a pillow to help blood flow while you sleep.
- Watch your salt intake. When you drink a lot of salt, more fluid flows into your blood vessels, which can increase the pressure in your veins. Excess fluid penetrates the tissues and causes edema. Drink plenty of water to help your body maintain proper fluid balance.
- Keep track of your weight. The female body changes during pregnancy, the future mother gains weight. The higher the body weight, the more pressure the weight puts on the veins in the lower extremities. The doctor will evaluate the gains and clarify the weight norms.
VARICOSIS AFTER BIRTH
The most important concern for pregnant women is whether varicose veins will disappear after pregnancy. Varicose veins usually disappear 3 months after the baby is born. If the changes do not go away after 3 months, you should contact a phlebologist.
Manifestations of varicose veins that first appeared when having a baby usually go away with little or no treatment. However, the more severe the changes, the more likely they are to remain after delivery and require treatment. Varicose veins in the vagina or vulva almost always resolve naturally after delivery.
WHAT ARE THE COMPLICATIONS OF THE DEGREES OF VARICOSIS
Varicose veins can cause serious complications. The risk of developing dangerous conditions increases: blood clots and venous ulcers.
There are two main types of blood clots. Superficial venous thrombi form in the saphenous veins. They do not usually migrate to the lungs. Dangerous deep vein thrombosis. The blood clots that form in them can break off and enter the pulmonary vessels. It is important to see a doctor immediately if:
- varicose veins harden, like a rope;
- surrounding tissue is warm, painful, or inflamed;
- there are noticeable changes in the color of the vein;
- ulcers appear on the skin;
- severe and painful swelling appears in one leg.
In these cases, the phlebologist will determine the treatment tactics, including minimally invasive surgical methods, to eliminate the inflammation, the risk of life-threatening complications.