Varicose Veins In Pregnancy
Varicosity means distension of the superficial veins of lower limbs because of the damage to the walls in the venous system
The disease presents as spectrum ranging from visible varicosities, spider veins, lower leg edema, itching and lower leg ulcers.
Pregnant women are more at risk of developing varicose veins.
Most propagated theory about its cause is mechanical factor. it is said that the increased size and weight of the pregnant uterus puts pressure on inferior vena cave and hampers return of venous blood towards heart. It leads to pooling of blood in the veins.
But what is practically seen is that the varicose veins start to develop even before first trimester is over. By this time the uterus is not big enough to cause weight related complications.
Further if another woman is having a pelvic tumor of the size of gravid uterus, she does not necessarily will develop varicose vein.
So, this leaves us to the next question what does cause higher risk of varicose veins in the pregnancy?
Now, I will discuss with you the reason behind higher chances of varicose veins in pregnant women.
See there is significantly increase level of hormones progesterone and estrogen during pregnancy.
Estrogen causes increase in blood supply to the uterus. This in turn leads to increase in venous return through veins towards heart.
The other hormone progesterone functions as a smooth muscle relaxant of the walls of veins. When both these factors combine the result is pooling of blood in the lower limbs and development of varicosities.
A couple more risk factors are
-Family history
-Advanced maternal age
-Multiparous woman
-Multi fetal gestation
The most common symptoms of varicose veins are
-Edema
-Leg pain
-Night cramps
-Tingling and heaviness of legs
-Visible varicosities
Diagnosis
A special venous ultrasound known as duplex ultrasound is used for diagnosis of varicose vein and mapping its tributaries.
Treatment
Non-surgical treatment include
-Compression stocking
-Rest
-Water immersion techniques
-Foot massage
Generally, surgery is avoided during pregnancy as for majority of women the symptoms subside within 3 to 4 months of pregnancy.
If at all surgery is deemed necessary the procedures are: –
-Ablation of great and short saphenous veins using thermal energy
-Venous stripping and ligation