Pregnancy and varicose veins

Varicose veins are a chronic disease of the superficial veins of the lower extremities. During pregnancy, the disease progresses due to changes in a woman's body. 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 in the body increases, uterine volume increases, and the inferior vena cava compresses the lumen. What happens to the body:

  • blood flow is redistributed - in addition to the blood circulation, the embryonic circle appears;
  • increases the venous load on the circulatory bed of the pelvis and lower extremities, makes it difficult for blood to flow from the legs to the heart;
  • body weight increases;
  • the volume of circulating blood doubles;
  • increases the load on the heart muscle;
  • increased blood clotting;
  • slows venous blood flow;
  • venous vessel walls weaken under the influence of progesterone;
  • increase in intravenous venous pressure (especially in the legs).

How do varicose veins develop?

Increased levels of progesterone, which is characteristic of the hormonal background of pregnancy, weaken the muscle tone of the venous wall along the vascular bed of the body. Increased blood volume in blood vessels with weakened walls exceeds and deforms them. Many pregnant women develop varicose veins.

Varicose veins are also possible due to the growth of the fetus and uterus. As they dilate, they press on the large vessels of the pelvic cavity (especially the inferior vena cava and the right ovarian vein), which disrupts the flow of venous blood to the heart. Venous occlusion of the main parts causes the vascular bed to overflow with blood, dilating the vessels of the pelvis, genitals, groin and lower extremities. As a result, varicose veins of the superficial system are formed. At the same time, the deep system of blood vessels of the lower extremities does not suffer, because they are located in a muscular position.

Symptoms of varicose veins

Often everything starts with visual manifestations. Vascular networks, reticular veins appear. In addition, the clinical symptoms are combined: swelling of the lower extremities by the end of the working day, heaviness, fatigue, burning sensation in the legs. Some patients experience a condition such as restless legs syndrome.

In more advanced stages, skin changes (redness, induration, pain) may be observed along the course of varicose veins. This condition is characterized as thrombophlebitis. Trophic changes in the skin may also be associated with the formation of trophic ulcers in the affected lower extremities.

Varicose veins of the vulva and vagina

A characteristic venous pattern appears in the genital area. Gradually, the varicose veins expand and swell. This worries the woman. If he does not go to the doctor for help, inflammation, thrombosis and ulcers join the varicose veins. Varicose veins in the vagina are more difficult to distinguish because of their similarity to normal inflammation of the genitourinary system.

Symptoms:

  • heaviness in the lower abdomen, restlessness, excruciating pain;
  • burning sensation when urinating; itching at the entrance to the vagina after emptying the bladder;
  • pain during bowel movements;
  • Anxiety and pain during sexual intercourse.

Women consult a gynecologist complaining of discomfort, pain and blemishes during sex. During the examination (vaginal examination) the doctor makes a diagnosis. He gives recommendations that need to be followed.

Early diagnosis prevents the possibility of complications. With the use of modern treatments for emergency indications, a pregnant woman is relieved of vaginal varicose veins long before delivery.

It is therefore important:

  • early registration for pregnancy;
  • time to take tests;
  • discuss changes in well-being, especially those that are painful, with the attending physician;
  • Do not have sex, it is dangerous for varicose changes in the vagina and vulva.

During childbirth, varicose veins of the vagina are complicated by trauma to the modified vessels, and venous bleeding opens. This becomes a serious complication in the postpartum period.

If the doctor has good reasons to avoid such a risk, the woman is hospitalized shortly before the expected date of birth and a scheduled caesarean section is performed.

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

Stagnation of venous blood in the pelvis helps to dilate the blood vessels involved in the blood supply to the uterus, bladder, rectum and anus.

Particular attention should be paid to this type with varicose veins of the lower extremities. Do not neglect the information that indicates heredity from family history.

Symptoms:

  • severe pain;
  • bleeding, spot after sexual intercourse, blood in the urine, feces mixed with fresh blood;
  • varicose veins of the uterus (detected during ultrasound);
  • external and internal hemorrhoids (determined during the examination).

If the attending physician finds varicose veins of any localization in a pregnant woman, she is sent for a consultation and registered with a phlebologist.

What are dangerous varicose veins during pregnancy

Any pathological condition during pregnancy and childbirth is dangerous.

Risks associated with varicose veins during pregnancy:

  1. Varicose veins in the pelvic organs affect the blood circulation in the "mother-fetus" system. With severe disorders of venous outflow, placental blood flow suffers, which is dangerous for the health and life of the unborn child.
  2. Varicose veins of the pelvic organs are especially dangerous. In late pregnancy, the fragile walls of pathologically altered blood vessels are damaged. Internal or vaginal bleeding occurs.
  3. The risk of bleeding increases during childbirth.
  4. With severe stress during childbirth, thrombi can disrupt with thrombophlebitis of any localization, which increases the risk of death.

The doctor and phlebologist in charge of the pregnancy work together to develop a treatment plan.

Prevention of varicose veins and its complications during pregnancy

Key recommendations:

  1. Early consultation with a gynecologist, registration for pregnancy. Implementation of expert advice. Regular visits to the antenatal clinic.
  2. Healthy, active lifestyle: outdoor walks, Pilates for pregnant women, yoga, swimming, aqua aerobics. Avoid saunas, baths, hot baths, exposure to the open sun.
  3. Proper nutrition with enough vitamins, minerals and fiber. Eliminate sweet, fatty, fried, smoked, floury, starchy foods. Body weight monitoring.
  4. Drink enough water.
  5. Give up bad habits.
  6. Loose clothes made of natural fabrics. Refrain from high-heeled shoes and narrow ballet flats. Wear comfortable, soft shoes made of natural materials with comfortable shoes and back support.
  7. Breaks for warming up and walking during work.
  8. Lie on your left side, reduce the pressure of the uterus on the inferior vena cava and the right ovarian vein.

This will prevent the further development of varicose veins and its complications.

Diagnostics

There is no problem in the diagnosis with damage to the superficial vessels of the lower extremities, vulva, access to the vagina, the appearance of external hemorrhoids. The doctor examines the patient, taking into account his complaints and general information about his medical history.

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

  • dilation of the vessels of the uterus seen on ultrasound.
  • Internal hemorrhoids are palpated by examination of the rectal finger.
  • Vaginal varicose veins are identified during a vaginal examination.
  • Damage to the bladder when blood is seen in the urine - when there are no other causes and changes in the vessels in neighboring organs.

The results of regular examinations of a pregnant woman performed in accordance with a standard protocol are important for the management of pregnancy. For example, a urine test that contains blood.

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

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

The method defines:

  • the degree of development of varicose veins;
  • localization and degree of deformation of venous valves;
  • the severity of the violation of the direction of blood flow through the veins (from the heart downwards and in the opposite direction to the emergency hostages);
  • presence of changes in the surrounding tissues.

In severe cases (with suspected spontaneous rupture of internal venous vessels and bleeding), magnetic resonance imaging is performed.

Methods of treatment

These include:

  • wear compression underwear;
  • leg lift;
  • immersion in water
  • Determination of phlebotonics from the 3rd trimester
  • use of local resources.

Compression stockings

Wear it all day, go out at night. Socks help the arteries and leg muscles move blood by squeezing the legs firmly. The compression ratio depends on the type and brand.

Lifting the foot

If you lie on your back several times a day and lift your legs, lean against a wall or a headboard, the condition of the arteries improves significantly. Especially if you combine walking in the fresh air, gymnastics for pregnant women, yoga.

Immersion

When the feet are swollen, a little warm baths with salt help. The feet are immersed in a pool of salt water for 15-30 minutes. Hemorrhoids and varicose veins of the vulva are also prescribed sedentary hot baths with a weak solution of salt or potassium permanganate.

Prevention of complications is the main method of treatment of pregnant women with varicose veins. In case of complications, specialists treat the patient according to the situation, taking into account the individual characteristics of the patient, general health, the severity of the varicose veins and the risks associated with it.

In pregnant women, radical methods are rarely used by doctors and only for health reasons (with the risk of death).

10.02.2022