New Moms

Pregnancy: Venous Insufficiency, Varicose Veins, Spider Veins and Treatment

CHANGES IN PREGNANCY

In pregnancy, a woman’s body undergoes many physiological changes. There is a significant increase in blood volume as the body adjusts to new growth and hormonal changes.  The rate at which blood is taken back to the heart is also slowed during pregnancy. This creates an increased pressure inside the veins, which are already working against gravity to take blood from the legs back to your heart. In addition to large volumes of blood flow, there is also an increase in the hormone known as Progesterone. Progesterone causes the vessel walls in your lower extremities to become relaxed or weakened. This weakening, along with a decreased speed of blood flow back to the heart contribute to development of venous insufficiency, varicose veins and spider veins during pregnancy.

SAPHENOUS VEINS DURING PREGNANCY

As your body tries to accommodate to these physiological changes, your saphenous veins may be greatly affected. As your baby grows, so does the pressure on the largest vein of the body known as the Vena Cava. This vein is located in the abdomen and channels blood to other veins in the legs. The increased pressure, in combination with Progesterone, cause dilation of the saphenous veins. As the valves become separated, they can no longer prevent back flow of blood. This causes blood to reflux or pool in the lower extremities. As this occurs, symptoms such as pain, aching, burning, itching, heaviness, fatigue and swelling may develop. A thorough vein mapping or ultrasound can identify venous insufficiency of the saphenous vein if such symptoms occur. Treatment such as compression socks, exercise, leg elevation may help with symptoms. Radiofrequency ablation may be necessary however, to close down dilated and refluxing saphenous veins.

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VARICOSE VEINS DURING PREGNANCY

Varicose veins are the large swollen veins that often bulge near the surface of your skin. They can often cause symptoms to the surrounding skin such as itching, burning, tenderness to touch or throbbing. Nearing the third trimester, as the progesterone and pressure increases in the veins, some vessels tend to become tortuous and evolve into what we know as varicose veins. While varicose veins can develop at any given time, many women first notice them during the course of their pregnancy. Once formed, varicose veins tend to worsen with each subsequent pregnancy.

Although varicose veins can fade away after giving birth, the damaged vein does not dissolve or go away completely. Treatment such as phlebectomy, or removal of varicose veins through micro-incisions, is a simple solution to getting rid of varicose veins after pregnancy.

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SPIDER VEINS DURING PREGNANCY

Telangectasias, also known as spider veins, are also commonly noticed during pregnancy. While spider veins are harmless and typically asymptomatic, they can worsen during the long 9 months that a woman carries a child and tend to develop in large unsightly clusters on the thighs, calves and ankles. Very small injections of a sclerosant solution into the vein can make these veins dissipate or fade significantly in most individuals.

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PREVENTION AND MANAGEMENT OF VEIN CHANGES DURING PREGNANCY

The following measures have been proven effective in aiding in the management of vein related changes and discomfort during pregnancy:

  • Weight management: Striving to keep within your recommended weight range for your particular stage in pregnancy can help avoid increased pressure and development of varicose veins.
  • Leg Elevation: Elevating your legs when sitting or lying down will assist the blood in flowing from the legs to the heart.
  • Exercise: Even a brisk walk once every hour is extremely beneficial during pregnancy. Avoid sitting or standing for long periods of time without taking a break to get up and move. Things like bed rest and fatigue often make it difficult to be able to exercise during pregnancy. Exercises like daily walking, water aerobics and prenatal yoga are great options for exercise during pregnancy. If you are placed on bed rest, simple leg exercises such as pointing your toes, ankle rolls and gentle stretches will greatly improve your circulation. Exercise will not only allow you to have more energy and a healthier baby, it will also help you in managing discomfort from venous insufficiency or varicose veins that develop during pregnancy.
  • Sleep on your left side: With the Vena Cava vein being on the right side, lying on your left side relieves the vein of the pressure placed on it by the uterus. This will allow for a decrease in pressure in the veins of the leg and feet. Using a pillow or wedge at night can help you comfortably sleep on your left side while elevating your legs.
  • Avoid restrictive clothing: Restriction in the pelvic area, abdomen and legs can lead to an increase in venous pressure. Avoiding restrictive tops and bottoms will lead to more comfortable pregnancy.
  • Use compression socks: Prescription grade compression socks are especially effective in reducing swelling in the legs and ankles during pregnancy. Not only will it help in swelling, but it will help manage discomfort in the legs that accompany venous insufficiency and varicose veins. Compression stockings such as knee high and thigh high compression can be purchased through our Compression Center.

While all of these measures are effective and proven to help in discomfort and development of additional varicose veins, we know that 30% of women will develop venous insufficiency in their first pregnancy despite attempts to avoid it. Risk factors such as a family history of bad veins and hormonal changes during pregnancy are unavoidable. In these circumstances, development of incompetent veins may be inevitable.

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WHEN TO SEEK TREATMENT

Although most symptoms such as discomfort and visible varicose veins occur during pregnancy, it is neither safe nor recommended to receive treatment during pregnancy. A period of three months post-partum is recommended if immediate treatment is desired. Heart of Dixie Vein and Vascular Center provides multiple treatment options such as radiofrequency ablation, phlebectomy of varicose veins and sclerotherapy for unsightly spider veins. To learn more about venous insufficiency and treatment options after pregnancy, contact us today. Members of our vein team will help you in taking the proper steps to restoring health back to your legs.