VARICOSE VEINS DURING PREGNANCY
It is very common for vein problems to develop during pregnancy, including varicose veins of the legs, varicose veins of the vulva, and hemorrhoids (which are basically varicose veins of the rectum and anus).
Why does this happen?
During pregnancy, three things occur that greatly affect the veins of the lower body:
1. Blood volume increases. The veins dilate to accommodate this extra volume.
2. There are increased levels of hormones, including estrogen, progesterone, and relaxin. Estrogen causes the veins to dilate, progesterone promotes laxity of the connective tissue, and relaxin causes the muscles of the vein wall to relax. The cumulative effect is to help the body adjust the increased blood volume and to make the pelvis easier to expand as the baby is being delivered. Unfortunately, these hormonal surges can also contribute to the development of varicose veins during pregnancy.
3. The uterus enlarges. This causes external pressure on the veins of your lower abdomen and pelvis.
Fortunately, the vein problems resolve within several weeks after delivery in most women.
Some women will find vein issues occur and resolve with the first pregnancy, but then in subsequent pregnancies, the vein problems will return earlier with more severe symptoms and take longer to resolve after delivery.
In some cases, the vein problems do not resolve and will need to be addressed.
There are several preventative measures the women can take during pregnancy:
1. Avoid prolonged sitting or standing in the same position.
2. Wear flat shoes. This will help your calf muscles pump the venous blood out of your legs.
3. Exercise regularly as is appropriate for your pregnancy. Daily walks are good.
4. Wear support stockings.
5. Keep hydrated.
Although varicose vein surgery is not generally recommended during pregnancy, there are rare cases where the symptoms are so severe, definitive treatment could be considered. The treatments are only performed during the last trimester. This must be assessed on an individual basis.
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Varicose Vein often improve or resolve after pregnancy.
Varicose Veins one month post-partum
Varicose Veins, same patient, 18 months post partum.