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Varicose veins during pregnancy

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Varicose veins during pregnancy

Among the common (and painful!) disorders of pregnancy, there are varicose veins, those blue veins that appear under the skin’s surface. How can we get rid of them?

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Pregnant, get rid of varicose veins

When you are expecting a baby, your legs are put to the test. They swell, become heavy, painful, and sometimes abnormally dilated veins appear under the skin: varicose veins. They are the expression of a chronic disease called venous insufficiency, characterized by a poor return of blood to the heart. The veins are equipped with “valves” to prevent blood from flowing back down to the legs. If these valves fail, blood circulation slows down, and blood stagnates in the lower limbs. It distends the vein walls and promotes the development of varicose veins. Anyone can develop varicose veins, but the genetic factor is decisive.

The risk is four times higher if one of the direct parents, father or mother, is affected. And six times more when both parents are affected. Women are more likely to be affected by this condition, particularly during pregnancy, a period of high risk for the veins. From the first months, the vein walls can become fragile under the effect of progesterone. This hormone, whose primary role is to distend the uterine muscle, will also dilate the vessels. At the end of pregnancy, the phenomenon is accentuated, but this time it is the volume of the uterus and the weight of the baby, which causes a compression of the deep veins and thus hinders the venous return. Other factors are involved, such as weight gain or the number of pregnancies. If you are expecting your second or third child, you are more likely to have varicose veins. Pregnancy is also accompanied by other, more benign circulation disorders, such as spider veins. These small, very superficial red or blue vessels, visible on the lower part of the body, are unsightly marks but not severe. They reveal a slight venous insufficiency and can remain at this stage or develop into varicose veins.

How to reduce varicose veins?

Varicose veins can appear without warning, but our body usually sends us warning signs. The first symptoms of venous insufficiency are localized pain in the lower limbs and heavy and swollen legs, which we know well when we are expecting a baby. Simple measures should be taken to limit these discomforts. To begin with, you should try to stay active. A sedentary lifestyle is an aggravating factor in venous insufficiency. It is not because you are pregnant that you have to give up all sporting activities, and if you don’t feel like swimming or cycling, opt for walking, which is excellent for stimulating venous return. To reduce pain, we (or our partner) massage our legs from the bottom to the top, either with two perfect gloves or with a decongestant cream, and we finish our shower with a jet of cool water along our legs from the bottom to the top.

When pregnant, lymphatic drainage is not contraindicated, as long as it is done by hand. On a daily basis, we raise our legs when we are in a sitting position or during the night; we do not go out in the sun because the heat accentuates the dilation of the vessels. The objective is always the same: avoid blood stagnation in the legs, ankles, and feet. Another reflex is to eat a balanced diet and drink plenty of water. Vitamins C and E and minerals such as zinc and selenium are involved in collagen production, which our vessels need to be resistant.

Compression stockings and venotonics during pregnancy

In addition to hygiene measures, there are different types of treatment for varicose veins. Compression stockings are the most effective method for improving venous return and limiting the risk of complications. By compressing the muscle, they cause an external counter-pressure which will support the superficial veins and thus prevent their dilation. They can be worn daily as soon as the first symptoms appear if you are often sitting or standing. In high-risk situations such as a long plane or car journeys, they are essential. Compression stockings or socks are divided into three classes according to the pressure they exert on the leg. In all cases, you should ask your doctor for advice; they can prescribe a model adapted to your morphology and the degree of severity of your venous insufficiency. If you still feel strong pain in your legs despite this treatment, you can turn to venotonics.
These drugs restore the tone of the vein walls and increase the speed of blood return to the heart. They are authorized during pregnancy but, “by prudence, I advise rather those which are containing extracts of plants like Daflon, than the chemical substances,” specifies the phlebologist. Venotonics are no longer covered by health insurance, unlike compression stockings.

When pregnant, if you have varicose veins, the most reasonable thing to do is consult a phlebologist for an echo-Doppler. This ultrasound of the lower limbs allows the state of the deep vein network to be visualized. The specialist examines the blood flow, the state of the veins, and varicose veins. It is essential to monitor because varicose veins can sometimes worsen. The risk of venous thrombosis, better known as phlebitis, is multiplied by five in pregnant women. This complication occurs when a blood clot blocks a vein, causing an inflammatory reaction: a hot, red, and painful cord appears on the part of a vein in the leg or thigh.

Wait until the end of pregnancy to be treated

No treatment to eliminate varicose veins is possible during pregnancy. Fortunately, these large veins disappear naturally after delivery most of the time, so you need to be patient. In general, doctors recommend waiting six months before intervening. When the varicose vein is not very deep, sclerosis or laser surgery can be used, the former being the least invasive method. Under ultrasound control, the doctor introduces a sclerosing product into the diseased vein to reduce its diameter. On the other hand, the endovenous laser destroys the varicose vein but without extracting the vein: it is a very effective and almost painless technique.

But generally speaking, if the varicose veins are not severe, it is better to wait until the end of one’s pregnancies before starting radical treatments. If, on the other hand, the veins are very sick, surgery is strongly recommended. Performed under general anesthesia, the operation called “stripping” consists of removing the affected vein. After these treatments, regular monitoring of the venous system is necessary to avoid the appearance of new varicose veins.

Conclusion

Varicose veins are prominent, bulging blood vessels that are most often seen in the legs but may appear practically anywhere in the lower half of the body. Numerous factors contribute to the development of varicose veins during pregnancy, including increased blood volume, which enlarges the veins, and the increasing baby’s weight, which pulls on the big blood arteries in the pelvic, changing blood flow.

If your varicose veins persist after the baby is born, you may consider medical treatment or surgical removal at that time, but not during pregnancy.

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