Causes Of Varicose Veins During Pregnancy & Its Treatment

Manageable varicose veins occurring from common pregnancy changes are seldom a concern.

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Varicose veins are twisted enlarged veins often appearing red, dark purple, or blue. They commonly occur on the legs but may also be found on the buttocks and vaginal area during pregnancy (1) (2). Varicose veins when pregnant, usually develop in the third trimester affecting around 40% of pregnant women (3) (4). They are harmless but can cause pain, itching, and discomfort and subside after pregnancy.

Read on to know the causes, symptoms, and treatment options of varicose veins during pregnancy.

Causes And Risk Factors Of Varicose Veins During Pregnancy

When you walk, the calf muscles help pump the blood back to the upper part of the body. The leg veins have one-way valves that stop the blood from flowing back to the legs. During pregnancy, these valves do not work properly due to pressure, weakening or hormonal factors (progesterone and relaxin), accumulating the extra blood in the veins, causing them to bulge and form varicose veins. When the blood collects in the rectal vein, causing it to swell, it gives rise to hemorrhoids during pregnancy (5) (4).

The following factors could increase your risk of varicose veins during pregnancy (5) (4) :

  • Increase in the volume of blood to support the baby’s growth.
  • Heavy weight of the baby applies pressure on the pelvic veins and obstructs the blood flow from the legs to the heart.
  • Hormonal changes affect the vein walls, causing them to become softer and inefficient.

Some possible risk factors of developing varicose veins are (6):

  • Genetic factors
  • History of varicose veins in a previous pregnancy
  • High body mass index
  • Standing or sitting for long periods
  • Increasing age (7)

Symptoms Of Varicose Veins During Pregnancy

Varicose veins generally appear at the back of the calves or inner part of the legs. Some symptoms include (4) (7):

  • Slight swelling in the ankles or feet
  • Aches and throbbing in the legs and/or feet
  • Heaviness in the legs
  • Leg cramps, especially night cramps
  • Itching
  • Painful vulva in case of vulvar varicose veins (vulvar varicosities)

Complications Of Varicose Veins During Pregnancy

Varicose veins generally do not cause any problems and resolve after pregnancy. However, sometimes, they may lead to other serious problems such as (8):

  • Formation of sores or ulcers: When blood stays collected in the vein for a long time, it could lead to sores or ulcers.
  • Bleeding: Since the skin over the varicose veins becomes thin, it could result in bleeding.
  • Blood clots just below the skin (Superficial thrombophlebitis): These clots feel warm, firm, and tender. They are swollen and painful.
  • Deep vein thrombosis: These clots are deep under the skin that usually form when you sit continuously for long hours. Though there are no specific symptoms of this clot other than pain or swelling, they may become serious because these blood clots may break and go to the lungs, brain or heart and cause blockages. This condition is called pulmonary embolism, characterized by breathing difficulties, increased heart rate, chest pain, and even death.

Signs You Should See The Doctor

Varicose veins cause discomfort and pain but can be managed at home; however, you should seek a doctor’s advice if the symptoms become serious. Some symptoms that you should not ignore are (2) (6):

  • Warm, tender, swell or red calf (a sign of deep vein thrombosis)
  • Bleeding veins
  • Rash on the legs or ankles
  • Alteration in the color or thickness of the skin
  • Headache, blurred vision, and stomach pain

Ways To Manage Varicose Veins During Pregnancy

Varicose veins cause considerable pain and discomfort, but since they are hereditary and related to circulatory changes in the body, they cannot be prevented. However, simple management techniques may help in alleviating the discomfort (2) (4) (6).

  • Take adequate rest
  • Sleep on the left side to help reduce the pressure on your large veins
  • Elevate your legs while sitting
  • Don’t sit cross-legged
  • Walk or exercise lightly to improve blood circulation
  • Wear loose and comfortable clothes
  • Wear compression stockings
  • Manage weight gain during pregnancy
  • Include foot exercises
  • Apply cold compresses or ice packs on the swollen areas
  • Wear comfortable, flat shoes to improve the blood circulation in the legs
  • Reduce sodium in the diet to prevent the veins from swelling
  • Drink plenty of water and include fiber in the diet to reduce constipation

Treatment Of Varicose Veins After Pregnancy

Varicose veins do not affect you and your baby in any way (7). They usually resolve without treatment within three to four months after delivery; however, the recovery might take around one year in some women.

Surgery for varicose veins is not suggested during pregnancy, but only upon a doctor’s suggestion can opt for it if the condition does not improve after a year (5).

Medical procedures for the treatment of varicose veins are (7) (8):

  • Endovenous thermal therapy: This treatment involves heat-sealing the veins with the help of laser treatments or intense radiofrequency.
  • Sclerotherapy: A solution is injected into the veins to close them. This stops the blood flow through that vein, turning it into scar tissue.
  • Closure system: The procedure works well for veins just beneath the skin. The vein is closed by injecting an adhesive into the vein. After the procedure, the other healthy veins help in the flow of blood.

Frequently Asked Questions

1. Can compression stockings help prevent varicose veins?

Compression stockings can relieve the symptoms of varicose veins by improving blood circulation in the veins. They are tight at the foot and become loose as they get higher. They are usually worn for the entire day.

If you have mild symptoms of varicose veins, you can use a support pantyhose or knee socks to help reduce swelling and pain. For severe conditions, special compression stockings are recommended. It may take a while to get adjusted with compression stockings and wear them all day; however, you may wear them comfortably once you adapt to them. If you face any discomfort, reach out to your doctor (9).

2. Will surgical removal of varicose veins affect the blood flow?

No, the surgical removal of varicose veins does not affect the blood flow because the healthy veins (especially the deep veins) take over the task of returning the blood to the heart. However, surgery is suggested only when,

  • There is a risk of ulceration due to varicose veins.
  • The varicose veins are bleeding.
  • There is inflammation in the varicose veins.

The surgery reduces the pressure in the veins, thus preventing the varicose veins from growing. Regular exercise and walking are recommended to heal the operated leg faster (10).

3. Can varicose veins burst during delivery?

One study demonstrated that in women with vulvar varicose veins, there could be an increased risk of vein rupture and bleeding during labor or childbirth (11).

4. Why are varicose veins worse at night?

The symptoms of varicose veins (including swelling and leg cramps) may strike anytime during the day or night. However, in some people, the pain and discomfort may increase during the night due to prolonged standing during the day and if the weather is warm at night (12).

Varicose veins during pregnancy may be worrying you; however, in most cases, they are harmless and resolve completely in a few months after delivery. The pain and discomfort that come along with the condition could be managed with simple and effective remedies. However, it is always advisable to contact doctors and share your concerns. They will be the best people to help you enjoy a safe and healthy pregnancy.

Key Pointers

  • Increased blood volume, hormonal fluctuations, and genetic factors are a few conditions that can lead to varicose veins during pregnancy.
  • It presents with symptoms such as swollen feet, pain in the legs, cramps, and itchiness.
  • The condition is typically harmless and can be managed with certain home remedies.
  • However, your doctor may recommend a medical procedure upon the persistence of symptoms or in case of complications.

References

  1. Varicose Veins.
    https://www.nhs.uk/conditions/varicose-veins/
  2. Treat Varicose Veins Naturally During Pregnancy.
    https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/treat-varicose-veins-naturally-during-pregnancy/
  3. Varicose Veins in the Legs: The Diagnosis and Management of Varicose Veins.
    https://www.ncbi.nlm.nih.gov/books/NBK327998/
  4. Hemorrhoids and Varicose Veins in Pregnancy.
    https://www.cedars-sinai.org/health-library/diseases-and-conditions/h/hemorrhoids-and-varicose-veins-in-pregnancy.html
  5. Varicose veins.
    https://www.pregnancybirthbaby.org.au/varicose-veins
  6. Varicose veins in pregnancy.
    https://www2.hse.ie/conditions/varicose-veins-pregnancy/
  7. Varicose veins in pregnancy: what you need to know.
    https://www.nct.org.uk/pregnancy/worries-and-discomforts/pregnancy-related-conditions/varicose-veins-pregnancy-what-you-need-know
  8. Varicose veins and spider veins.
    https://www.womenshealth.gov/a-z-topics/varicose-veins-and-spider-veins
  9. Compression Stockings for Varicose Veins.
    https://www.uofmhealth.org/health-library/hw113550
  10. Varicose Veins: The Operation.
    https://circulationfoundation.org.uk/sites/default/files/2020-10/Circulation_Foundation_Varicose_Veins_Operation_Info_Leaflet.pdf
  11. Hadiza Moutari Soule et al., Vulvar varicose veins and pregnancy: childbirth management.
    https://www.clinical-medicine.panafrican-med-journal.com/content/article/3/157/full/#:~:text=The%20risk%20of%20vaginal%20delivery,during%20labor%20and%20vaginal%20delivery
  12. Varicose veins: Overview.
    https://www.ncbi.nlm.nih.gov/books/NBK279247/
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