pregnancy and varicose veins

Varicose veins are a chronic superficial venous disease of the lower extremities. During pregnancy, the disease progresses due to changes in the woman's body. The treatment of pregnant women is carried out under the supervision of the attending physician and phlebologist.

Varicose veins in the legs during pregnancy

Causes of varicose veins in pregnant women

During pregnancy, a woman's hormonal background changes, blood volume increases in the body, the uterus increases in volume and compresses the inferior vena cava lumen. What happens to the body:

  • Blood flow is redistributed - there is an additional, embryonic circulation of blood;
  • Increased venous load on the pelvic and lower extremity circulatory beds, making it difficult for blood to flow from the legs to the heart;
  • weight gain;
  • Circulating blood volume doubled;
  • increase the load on the heart muscle;
  • increased blood clotting;
  • slowed venous blood flow;
  • Under the influence of progesterone, the walls of the veins weaken;
  • Increased intravascular venous pressure (especially in the legs).

How is varicosity formed?

Elevated progesterone levels, characteristic of the pregnancy hormone background, weaken the muscle tone of the vein walls in the vascular beds throughout the body. The increased blood volume in the weak-walled blood vessels spills out and deforms it. Many pregnant women develop varicose veins.

Also, varicose veins may develop due to the growth of the fetus and uterus. When dilated, they compress the large blood vessels in the pelvis (especially the inferior vena cava and right ovarian vein), which disrupts venous outflow to the heart. Venous congestion in the lower portion allows blood to overflow the vascular bed, dilating the veins of the pelvis, genitals, groin, and lower extremities. As a result, varicose veins of the superficial system appear. At the same time, the deep system of the veins of the lower extremities is not affected because they are located in the musculature.

signs of varicose veins

Most of the time, it all starts with visual representation. Vascular network and reticular veins appear. In addition, clinical symptoms include: lower extremity swelling at the end of the workday, heaviness, fatigue, and a feeling that the legs are on fire. Some patients develop conditions such as restless legs syndrome.

In more advanced stages, skin changes (redness, induration, soreness) can be observed during the course of varicose veins. This condition is characterized by thrombophlebitis. Nutritional changes in the skin, and nutritional ulcers can also be added to the lower limbs on the affected side.

Vulvar and vaginal varicose veins

A characteristic venous pattern appears in the genital area. Gradually varicose veins increase and swell. This makes women very uncomfortable. If she doesn't see a doctor, inflammation, blood clots, and ulcers can join the varicose veins. Varicose veins in the vagina are more difficult to detect due to their similarity to common inflammations of the genitourinary system.

symptom:

  • heaviness, discomfort, pain in the lower abdomen;
  • burning sensation when urinating; itching at the entrance to the vagina after emptying the bladder;
  • pain during bowel movements;
  • Discomfort and pain during sex.

Women go to gynecologists complaining of discomfort, soreness and spots during sex. During an exam (vaginal exam), the doctor makes the diagnosis. He made recommendations that must be followed.

Early diagnosis can prevent the possibility of complications. By treating emergency indications with modern treatments, pregnant women can relieve vaginal varicose veins long before delivery.

Therefore, it is important to:

  • Early pregnancy registration;
  • It's time to do the test;
  • Discuss changes in well-being, especially pain, with the attending physician;
  • Do not engage in sexual intercourse, which is dangerous for varicose changes in the vagina and vulva.

Vaginal varicose veins can be complicated by trauma that alters blood vessels and bleeding from the veins during childbirth. This becomes a serious postpartum complication.

If doctors have serious reasons to avoid the risk, the woman will be taken to the hospital for a planned C-section shortly before her due date.

Varicose veins of the pelvic organs: uterus, bladder, rectum and anus (internal and external hemorrhoids)

The stagnation of venous blood in the pelvis causes dilation of the veins involved in the blood supply to the uterus, bladder, rectum, and anus.

Special attention should be paid to this type of varicose veins of the lower extremities. Don't ignore the information in the family history that suggests genetics.

symptom:

  • severe pain;
  • bleeding, spotting after sex, blood in the urine, stool mixed with fresh blood;
  • Uterine varicose veins (identified during ultrasound);
  • External and internal hemorrhoids (determined during examination).

If the attending physician finds any localized varicose veins in the pregnant woman, she will be referred for consultation and registered with a phlebologist.

What are the dangers of varicose veins during pregnancy

Any pathological condition is dangerous during pregnancy and childbirth.

Risks associated with varicose veins in pregnancy:

  1. Varicose changes in the pelvic organs can affect blood circulation in the "maternal-fetal" system. Severe violations of venous outflow and impaired placental blood flow are dangerous to the health and life of the unborn baby.
  2. Varicose veins of the pelvic organs are especially dangerous. During the third trimester, the fragile walls of pathologically altered veins are damaged. Internal or vaginal bleeding occurs.
  3. Increased risk of bleeding during labor.
  4. With the stress of childbirth, blood clots can rupture due to thrombophlebitis anywhere, increasing the risk of death.

The doctor leading the pregnancy and the phlebologist work together to develop a treatment plan.

Prevention of varicose veins and their complications during pregnancy

Main recommendations:

  1. Appeal to your gynecologist early to register your pregnancy. Implement expert advice. Make regular visits to the antenatal clinic.
  2. Healthy, active lifestyle: outdoor walks, maternity pilates, yoga, swimming, water aerobics. Say no to saunas, baths, hot tubs, and sun exposure.
  3. Proper nutrition with adequate vitamins, minerals, and fiber. Exclude sweets, greasy, fried, smoked, flour, starchy foods. Weight monitoring.
  4. Drink enough water.
  5. Say goodbye to bad habits.
  6. Loose-fitting clothing made from natural fabrics. Refuse to wear high heels and tight ballet flats. Wear comfortable, soft shoes made of natural materials with comfortable shoe and arch support.
  7. Take breaks during work to warm up and walk.
  8. Sleeping on the left side reduces the pressure of the uterus on the inferior vena cava and the right ovarian vein.

This will prevent further development of varicose veins and their complications.

diagnosis

Since the superficial veins of the lower extremities, vulva, vaginal entrance, and external hemorrhoids appeared, there was no problem in the diagnosis. The doctor examines it, taking into account the patient's complaints and general information about the medical history.

Varicose veins in the internal organs of the small pelvis are more difficult to detect: deep hemorrhoids, vagina, uterus, and bladder. sign:

  • Uterine veins are dilated, visible on ultrasound.
  • Internal hemorrhoids, palpable by digital rectal examination.
  • Vaginal varicose veins are identified during a vaginal exam.
  • Damage to the bladder when blood appears in the urine - if there is no other cause and there are changes in the veins of adjacent organs.

The results of routine examinations of pregnant women according to standard protocols for managing pregnancy are important. For example, a urine test that contains blood.

Decreased hemoglobin levels are often associated with internal chronic bleeding from damaged blood vessels. Elevated sugar increases the vulnerability of blood vessel walls to the effects of infection.

Doppler ultrasonography (USDG) of venous vessels is safe during pregnancy.

The method definition:

  • the extent of the development of varicose veins;
  • The location and degree of deformation of the venous valve;
  • The severity of the violation of the direction of blood flow through the veins (from the heart down to the opposite direction of the emergency collateral);
  • Changes in surrounding tissue.

In severe cases (suspected spontaneous rupture and hemorrhage of internally dilated venous vessels), magnetic resonance imaging is performed.

treatment method

This includes:

  • wear compression underwear;
  • leg lift;
  • immersed in water
  • Intravenous injection from the third trimester appointment
  • Use local resources.

compression stockings

Wear during the day, take off at night. Stockings compress the legs in a stable manner, helping the veins and muscles of the legs move blood. Compression ratio depends on type and brand.

leg lift

If you lie on your back several times during the day with your legs raised, leaning against a wall or headboard, your veins will improve significantly. Especially if you combine it with a walk in the fresh air, gymnastics for pregnant women, yoga.

immersed in water

When the legs are swollen, take a slightly warm bath with salt to help. Soak your feet in a basin of salt water for 15-30 minutes. For hemorrhoids and vulvar varicose veins, a sedentary warm water bath with salt or a weak solution of potassium permanganate is also prescribed.

Prevention of complications is the main approach to managing pregnant women with varicose veins. If complications arise, specialists treat them on a case-by-case basis, taking into account the patient's individual characteristics, general health, the severity of the course of varicose veins, and the risks associated with them.

Doctors rarely use aggressive methods against pregnant women, and only for health reasons (with death threats).

10.02.2022