Pregnancy: Venous Insufficiency, Varicose Veins, Spider Veins, and Treatment
Changes During Pregnancy
In pregnancy, a woman’s body undergoes many physiological changes. The development of a brand-new baby leads to a significant increase in blood volume as the body adjusts to new growth and hormonal changes. Because of the increase in volume, the rate at which blood is taken back to the heart is 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. A side-effect of 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, contributes to the development of venous insufficiency, varicose veins, and spider veins during pregnancy.
The last thing you need during pregnancy is a loss of self-esteem and leg pain due to these conditions. Here, we hope to offer some advice on what venous insufficiency is and how you can best avoid it during pregnancy.
Venous Insufficiency During Pregnancy
As your body tries to accommodate these physiological changes, your saphenous veins may be greatly affected. Your upper thighs have both a greater and a lesser saphenous vein that help direct blood back to the heart. Connected directly to your saphenous veins is the largest vein in the human body called the Vena Cava. This vein travels from the heart under the abdomen and channels blood to the saphenous veins in the legs.
As your baby grows, so does the pressure on the Vena Cava. The increased pressure, in combination with progesterone, causes dilation of the saphenous veins. As the valves become separated, they can no longer prevent the backflow of blood. This causes blood to reflux or pool in the lower extremities. Due to the combination of these factors, symptoms such as pain, aching, burning, itching, heaviness, fatigue, and swelling may develop.
If you are experiencing any of these symptoms during pregnancy, don’t hesitate to give us a call and schedule an appointment. A thorough vein mapping or ultrasound can identify venous insufficiency of the saphenous vein if such symptoms occur. Treatment such as compression socks, exercise, and leg elevation may help with symptoms, which we will discuss later. We also offer more technical treatment options such as radiofrequency ablation. This may be necessary to close down dilated and refluxing saphenous veins.
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 the touch, or throbbing. Nearing the third trimester, as the progesterone and pressure increase in the veins, some vessels tend to develop tortuous symptoms and evolve into what we know as varicose veins. While varicose veins can develop at any given time during the first pregnancy, varicose veins tend to worsen with each subsequent pregnancy.
Varicose veins can fade away after giving birth, but the damaged vein does not dissolve or go away completely. Treatment such as microphlebectomy, or removal of varicose veins through micro-incisions, is a simple solution to getting rid of varicose veins after pregnancy.
Telangiectasias, 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. They tend to develop in large, unsightly clusters on the thighs, calves, and ankles.
Spider veins are closely related to varicose veins. They are, in essence, widened blood vessels whose relaxed state allows blood to remain instead of returning to the rest of the circulatory system. Very small injections of a sclerosant solution into the vein can make the appearance of these veins dissipate or fade significantly in most individuals. The sclerosant solution used in the procedure is a solution of salt and other ingredients that make veins tighten to maintain proper blood flow.
Management of Veins During Pregnancy
The following measures have proven effective in aiding in the management of vein-related changes and discomfort during pregnancy:
- Weight management: Keeping within your recommended weight range for your particular stage in pregnancy can help avoid increased pressure and the development of varicose veins.
- Leg elevation: Elevating your legs when sitting or lying down will assist the blood flow 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 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 exercising during pregnancy.
- Limited mobility options: 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, but it will also help you manage discomfort from venous insufficiency or varicose veins that may 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 also help you comfortably sleep on your left side without rolling over.
- 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 a 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 they help reduce swelling, but they 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 relieve discomfort and prevent the 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, Heart of Dixie can help you manage your symptoms and discomfort.
To learn more about compression and how to purchase a custom fit sock for you
When to Seek Assistance
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 postpartum is recommended if immediate treatment is desired. Heart of Dixie Vein and Vascular Center provides multiple treatment options such as radiofrequency ablation, microphlebectomy of varicose veins, and sclerotherapy for unsightly spider veins. To learn more about venous insufficiency and treatment options after pregnancy, contact us today and schedule an appointment to discuss your unique situation. Members of our vein team will help you in taking the proper steps to restore health to your legs.