Pregnancy does a number on a woman’s body, especially their legs. Varicose veins are something that many pregnant women endure during their pregnancies. This article will help you figure out how to deal with varicose veins during any of your pregnancies.
Dealing with varicose veins
Genetics plays a big role in the development of varicose veins. This results in more diluted blood. The risk of developing varicose veins depends on the genetic predisposition of a woman. If your mom, aunt, or sisters have varicose veins, chances are, you would also develop varicose veins. You get a 21.5 higher chance of developing varicose veins as compared to those without family members with varicose veins.
To properly deal with varicose veins in pregnancy, we, first, have to understand the changes that occur in pregnancy. Pregnancy brings about an ordeal of changes in the body. This journey is no joke as this occurs for you to accommodate another living being inside one’s uterus and in preparation for the mother for labor and delivery.
Aside from genetics, multiple factors contribute to the development of varicose veins in pregnancy.
Pregnant women would often pump more blood from the heart as compared to non-pregnant women. To supply enough blood, the heart would double time its work and pump thirty to fifty percent more. This occurs to compensate for the demands of the uterus and placenta.
With the increased pumping of the heart, the blood subsequently compensates to achieve an increased volume. Plasma increases to about fifty percent while red blood cell mass increases to about twenty-five percent. These changes result in more diluted blood.
Both the increase in the amount of blood pumped by the heart and the increase in blood volume influence the development of varicose veins in pregnant women. These add to the increased venous pressure.
An enlarging uterus also contributes to the increased venous pressure on the lower extremities. The gravid uterus puts additional weight on the lower extremities to the point of altering the venous pressure at the femoral veins up to 24 mmHg at 9 months. Symptoms would vary from cosmetic problems to mild to severe leg discomfort.
So back to the question – how do we treat varicose veins in pregnant women?
First, we start with practices that would prevent or reduce your leg discomfort!
Elevate your legs
Your lower limbs, especially your feet and legs, are the most battered part of your body, more so in pregnancy. Giving your legs adequate rest while elevated improves the circulation of the blood. Elevation of the legs above the level of the heart promotes venous return. This prevents lower extremity venous stasis. However, you should be cautious in performing leg elevation, especially in the late trimester. The presence of difficulty of breathing should prompt you to stop performing leg elevation.
Yes, you guessed it right! Prolonged sitting or standing worsens the symptoms of varicose veins. Daily exercise could do wonders for you! American College of Obstetrics and Gynecologists recommends the same amount of exercise to pregnant women as with nonpregnant women as long as there are no obstetrical or medical complications involved.
One problem that leads to varicose veins is the failure in the muscle pump function of the calves. The calves are part of the support of the venous circulatory system of the lower extremities and in a situation where the calves do not perform a strong-enough pumping action, there would be an increase in the venous pressure in the lower limbs.
To combat this problem, pregnant women should perform walking exercises. The pumping action of the calves in a walk could empty your veins and this could relieve the edema and venous hypertension. Exercise significantly improves muscle strength and vein drainage, hence its role in the treatment of varicose veins.
Compression stockings are the answer
Another treatment for varicose veins in pregnancy is the use of graduated compression stockings. Doctors have used compression therapy for conditions involving venous and lymphatic insufficiency. Varicose veins, lymphedema, venous ulcers, and deep vein thrombosis, you name it, doctors would often prescribe graduated compression stockings.
Graduated compression stockings come in different pressures. Your doctor will prescribe you the appropriate pressure gradient Your doctor will prescribe you with the pressure depending on the severity of your varicose veins. The greatest degree of pressure is at the ankle and as it goes up your leg, the pressure will gradually decrease.
Compression therapy is the cornerstone of conservative varicose vein treatment. It is specifically designed to support your lower limbs.This is the reason why most doctors would prefer the use of compression stockings, especially for pregnant women. Compression therapy is a safe treatment for varicose veins for you as it is safe and non-invasive.
Persistence of severe leg edema, thickening or changes in the skin texture, ulcer formation, and other symptoms despite compression stocking use warrant an immediate consultation with your doctor. As much as possible, doctors avoid treatment of varicose veins with surgical interventions in pregnancy. In most cases, doctors would opt to move the surgery after your pregnancy.
There are a few cases where doctors would suggest surgery when you are pregnant. They only do a surgical intervention when symptoms are uncontrolled and worsening. Doctors would limit the surgical intervention in pregnant women with varicose veins to high ligation.
High ligation and vein stripping is a minor surgical procedure that involves making a small incision below the groin and behind the ankle or knee. The surgeon would then tie and clamp off the damaged vein. The surgeon then inserts a wire into the damaged vein. Afterwards, the surgeon places a cap on the end of the wire, then he/she strips the vein by pulling on the wire at the groin.
Performing high ligation and vein stripping between the third and seventh month of gestation is the safest. Doctors would use local anesthetics allowing the patient to be completely ambulatory afterward. (4) However, doctors are concerned about the recurrence of varicose veins in pregnant patients who undergo this procedure.
Remember, that a surgical procedure, especially in pregnant women, can only be if the benefits outweigh the risks. Doctors would not perform these procedures if not warranted by the condition!
In a nutshell
Most treatment offered for varicose veins during pregnancy involves conservative practices. For the mothers-to-be out there suffering from varicose veins, consult your doctor! Don’t be scared. The discomfort you are feeling can be remedied. You can try out my earlier suggestions such as leg elevation and daily exercise. For the rest, you can ask your doctors if you can use support stockings.
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