Varicose Veins in Pregnancy

Venous insufficiency and Varicose Veins is a very common problem in women and in pregnancy normally

varicose veins

Pregnancy and Birth are a critical time for the venous system, particularly in the lower limbs. Varicose veins and phlebitis are common.

tends to accentuate.

Varicose veins are veins that have a dilated, exhausted and sometimes tortuous aspect due to a degeneration of the venous walls. Consequently, there is a lose of containment capacity of their digestive tube effectiveness with frequent blood stagnation, flow reversal and edema in the districts concerned.

The veins in fact ensure the blood return to the head through a delicate but highly functional valvular apparatus system.

The reason why they tend to swell in some subjects is certainly linked to hereditary constitutional factors but other factors may play a role, and unfortunately not all are well known.

When the blood stagnates is easier for varicose veins to suffer inflammation (phlebitis) and there are higer chance of blood clots formation (thrombophlebitis). In these particularly delicate situations a more careful attention to the possibility of serious thromboembolic complications and for permanent results on the Venous System is required.

Pregnancy is definitely a possible causative onset factor. In fact, many women begin to suffer during their pregnancy. Otherwise, if the venous insufficiency is present, pregnancy is certainly an aggravating factor.

It is therefore advisable for pregnant women learn simple but effective hygiene standards for the venous system and in particular fo the veins of the lower extremities that are suscetible to higher hydrostatic loads.

Pregnancy has a negative effect on the legs venous system through two mechanisms: one related to the

varicose veins and pregnancy

Anatomical and functional changes that lead to the varicose vein. Desliming is associated with valvular deficiency.

endocrine progestin component (Progesterone action exhausts Vein Walls) and one mechanical dependent on the increase of hydrostatic pressure on venous circulation.

Hygienic hints are few but effective:

  • Avoid prolonged standing position, especially when forced to sit still;
  • Walking, organizing even small walks during the day;
  • Night’s rest;
  • Avoid excessive weight gain during pregnancy.

At the first symptoms, please consult your Doctor who will probably advise you to dress compression stockings during the day (their characteristics are extremely peculiar).

There is not an effective Varicose veins medical treatment to correct venous flaws once it has been determined, even during pregnancy. There are products that tend to strengthen the wall, but their use is not recommended in pregnancy.

The only medicine used in order to prevent the dangerous inflammatory and thrombotic complications are the Heparins (in particular the more modern ones with low molecular weight such as Enoxaparin). Heparins have the advantage to do not pass the placental filter and then to do not enter in the fetal circulation. They are also easy to manage and do not require special controls. They counteract the hypercoagulant tendency of blood during pregnancy. This is a trend that aims to protect women from bleeding during childbirth but that in the presence of varicose veins and venous pooling bring to thromboembolic complications.

It is clear that the use of pharmacological treatments occurs in specific cases and not in all forms of venous insufficiency; it is possible to control with the rules of hygiene and precautions that we have listed mild forms of Varicose Veins.

Another venous complication risk moment is the post-partum period, when the blood hypercoagulability becomes even more thrusted. In fact, with the birth enter in the bloodstream blood factors that stimulate inflammation by facilitating inflammations and veins thrombosis. After childbirth, many women can also see a worsening of hemorrhoids.

Early mobilization and Heparins use (even for 40 days after birth) are very effective.

 

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Filiberto Di Prospero
Medical Doctor, Consultant in Gynecology and Obstetrics, Endocrinology and Metabolism. Director of Gynecologic Endocrinology Unit at Civitanova Marche General Hospital (Italy). Private clinics in Civitanova Marche, Rome and Milan.

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