Varicose veins in the legs in pregnant women. Measures to prevent varicose veins during pregnancy and methods of treatment

Every woman wants to look good. Therefore, expectant mothers are often upset by cosmetic defects on the legs that appear in late pregnancy in the form of increased vascular pattern, "asterisks" and small veins on the legs. Friends and acquaintances often diagnose a pregnant woman with varicose veins in this case (and they are usually right). They can also suggest remedies to combat this ailment that have helped them in the past. But do not rush to the pharmacy, dear expectant mothers! Not all drugs recommended by friends are allowed for a pregnant woman. Today we will try to figure out how to deal with varicose veins, or, as doctors call it, with chronic venous insufficiency, varicose veins.

Varicose veins are observed in 20-40% of expectant mothers. Unfortunately, this disease often occurs during pregnancy: out of 15-20% of patients with venous pathology, 2/3 are women, while in 60-80% of cases the disease is associated with pregnancy. Quite often, varicose veins develop not only in women who previously suffered from mild forms of this disease, but also in healthy, at first glance, expectant mothers. The reason for this is this: the fetus in the uterus, with its weight, compresses the veins (lower vena cava and iliac), passing in the abdominal cavity. As a result, there is an obstacle to reverse blood flow, which entails an increase in venous pressure and, as a result, a violation of the elasticity of the walls of the venous vessels of the legs. Slowing blood flow in the varicose veins of the legs creates optimal conditions for the formation of blood clots and can lead to venous thrombosis - blockage of the veins. This situation is the cause of the development or exacerbation of varicose veins. This process is most susceptible to women with burdened heredity, whose mothers also have varicose veins. In addition, an increase in the amount of the hormone progesterone can lead to weakening of the walls of blood vessels. The result is venous insufficiency.

Remember that only a doctor should prescribe treatment to a future mother, since only he can determine the mechanism of the development of the disease and select the optimal drug. Pregnant women with a diagnosis of "varicose veins" are better observed in specialized centers. Take a referral from your obstetrician-gynecologist to a specialist phlebologist or surgeon, if this is not possible.

It is the phlebologist who will tell you which method of conservative treatment during pregnancy will alleviate your condition. He can prescribe you drugs that can improve blood circulation, reduce the permeability of the vascular wall, and prevent the formation of blood clots. Such systemic drugs (for internal use) include DOXY-CHEM. This drug should not be used in the first 3 months of pregnancy.

Local preparations include HEPATHROMBIUS (gel and ointment), which is available in dosages of 30,000 and 50,000 IU. Treatment begins with the use of HEPATROMBIN 50,000. When the condition improves, treatment is continued with HEPATROMBIN 30,000. An ointment or gel is applied in a thin layer to the affected surface 2-3 times a day. HEPATHROMBIN can be used at any stage of pregnancy, but only during regular visits to the doctor, since only he can assess the need for its appointment and effectiveness. If necessary, treatment with DOXYCHEM and HEPATHROMBIN can be combined (the effectiveness of treatment in this case increases).

So-called phlebotonics can be added to complex therapy - tablets with a venotonic, vein-strengthening effect (DETRMEX, GINKOR-FORT, VENORUTON, ENDOTELON, ESCU-ZAN, DOXIUM, etc.). DETRALEX is recognized as the preferred drug for the treatment of varicose veins during pregnancy, however, due to the lack of data on the penetration of the drug into milk, its use by nursing mothers is not recommended. VENORUTON is contraindicated for use in the first trimester of pregnancy, but it can be used during breastfeeding. The use of EN-DOTELON, ESCUZAN, DOXIUM during pregnancy and breastfeeding is contraindicated.

Along with phlebotropic drugs for varicose veins of the legs, drugs of other pharmaceutical groups are used. It can be:

• non-steroidal anti-inflammatory drugs (IBUPROFEN, DICLOFEMAK, etc. - in ointments and gels) and, if necessary, antibiotics;
• heparin-containing preparations (ESSAVEN-GEL, LIOTON 1000-GEL, etc.);
• enzyme preparations (WOBENZYM, FLOGENZYM);
• drugs that normalize blood clotting (PENTOXYFYLIN, ASPIRIN, DIPIRIDAMOLE (KURAITIL), nicotinic acid derivatives, etc.)

The use of these drugs during pregnancy and breastfeeding is extremely limited, they are prescribed according to strict indications by the attending physician, since they all affect the development of the fetus and the formation of organs and tissues, and their uncontrolled intake during pregnancy can lead to deformities and / or underdevelopment of organs. And drugs that affect the rheological properties of blood (its fluidity and coagulability) must also be used under the control of blood coagulation in order to avoid bleeding and hemorrhage. It is for these reasons that they should be used with caution, under the supervision of a phlebologist. It should be warned against the thoughtless use of certain types of therapy: only their reasonable combination can be the key to success in the treatment of venous insufficiency. Competent treatment allows for a fairly short time (usually 3-4 weeks) to achieve compensation of venous blood flow and eliminate the clinical manifestations of complications.

A variety of ointments and gels penetrate to a limited depth and, at best, can affect intradermal vessels without affecting other organs and systems, which are often one of the causes of varicose veins. In addition, although in a minimal dose, when they penetrate the skin, they are absorbed into the systemic circulation, and therefore they can have an effect on the fetus, which has not been studied in almost all gels and ointments.

Remember: if, when using gels and ointments, you notice severe redness in the area of ​​\u200b\u200bthe varicose vein, severe pain is felt, the temperature rises, heart palpitations or shortness of breath appear - immediately call an ambulance! This is the first sign of an inflammatory lesion of a vein - thrombophlebitis.

In general, varicose veins, or chronic venous insufficiency, is not a contraindication to pregnancy - it is just an excuse to be more attentive to your health. Do not try to hide diseased veins under a long skirt or trousers - it is better to go to the doctor and after a while, with the right treatment, you yourself will understand that varicose veins can be defeated.

Compression stockings

The optimal means of preventing the progression of varicose veins and at the same time preventing thrombosis is bandaging with an elastic bandage and wearing compression (squeezing) knitwear.

Put on stockings or bandage your legs in the morning without getting out of bed. Stockings (or an elastic bandage) should be worn all day. These funds must be combined with the use of anti-varicose drugs.

Compression stockings look like regular women's stockings, but are very tight in certain places, due to which they do not allow the veins to expand. With proper use, each pair of such "overalls" is worn for less than six months. The most important thing is that this does not violate the usual way of life of a woman. You just need to put on compression tights or stockings - forget about them, because compression knitwear is comfortable, it does not interfere with movement, the legs “breathe” freely in it.

The cost of such knitwear ranges from 30 to 100 USD. for a couple. The degree of compression is selected by the doctor. Please note that it is measured in millimeters of mercury, and not in "dens".

Conventional support tights, which are most often sold in pharmacies, squeeze the leg evenly and do not provide the correct distribution of compression, while therapeutic knitwear provides support in exactly the right areas. If we take the maximum pressure (in the ankle area, where swelling most often occurs) as 100%, then the knee will have 70%, and the area of ​​​​minimum pressure (40%) will be the thigh.

It is very important to start using such underwear as early as possible, preferably before pregnancy, then by the most crucial moment in your life you will have healthy veins. And the pregnancy itself will be easier. Naturally, prevention will need to continue after childbirth, especially if you already have varicose veins.

How to avoid becoming a victim of varicose veins during pregnancy?

• Avoid excessive or sudden weight gain.
• During pregnancy, get rid of stockings and stockings with tight elastic bands. For preventive purposes, it is advisable to wear compression stockings.
• After a hot bath or shower, rinse your feet with cool water while leaning forward.
• Don't squat.
• Don't lift heavy things.
• Wear shoes with medium heels (3-4 cm).
• Don't sit with your legs crossed.
• Don't smoke: There is a link between smoking and varicose veins.
• Take ascorbic acid and rutin (vitamins C and P). They have a strengthening effect on the wall of blood vessels and reduce their permeability. Usually these substances are included in multivitamin complexes.
• Keep your legs elevated while you sleep and rest, put them on the sofa when you read or watch TV.

This is an ectasia of venous vessels that arose in the gestational period and is pathogenetically associated with it. Manifested by heaviness, paresthesia, pain in the lower extremities and external genitalia, swelling, convulsive muscle twitches, trophic skin lesions. Diagnosed by examination, methods of ultrasonic angioscanning. During pregnancy, treatment is usually limited to compression therapy with adjustments in sleep and rest, physical activity, and nutrition. It is possible to prescribe phlebotonics, phleboprotectors, anticoagulants, antiaggregants. Surgical treatments are usually used after childbirth.

ICD-10

O22.0 Varicose veins of the lower extremities during pregnancy

General information

In 4% of patients, the disease affects the veins of the vulva, vagina, and small pelvis. With vulvar and vaginal varicose veins, discomfort, bursting, heaviness, itching are observed in the area of ​​​​the external genitalia. There may be swelling of the perineum and labia, contact bleeding from the vagina after sex. The syndrome of plethora of the pelvic organs is manifested by pulling or aching pains in the lower abdomen, which radiate to the lower back, sacrum, groin, and external genitalia. Characterized by dyspareunia (pain during intercourse). In severe cases, dysuric disorders are detected.

Complications

In the absence of adequate treatment, varicose veins in pregnant women can be complicated by the development of trophic ulcers, erysipelas, thrombophlebitis, thrombosis of superficial and deep veins, thromboembolism of the pulmonary artery and other great vessels during childbirth. In 40-45% of cases, fetoplacental insufficiency occurs with acute and chronic fetal hypoxia. In 25% of patients, anomalies of labor activity are observed (weakness of labor forces, discoordination of the contractile activity of the myometrium). With vaginal varicose veins, massive traumatic courses of the postpartum period are possible. Almost a third of women in labor have defects in the separation of the placenta and the discharge of the placenta. Long-term consequences of varicose veins that occurred during pregnancy are hemorrhoids, disabling chronic venous insufficiency, and pelvic pain.

Diagnostics

With the appearance of characteristic skin signs, the diagnosis of varicose veins during pregnancy usually does not present any difficulties. The tasks of the diagnostic stage are to determine the stage and localization of venous ectasia, to exclude other causes that can cause stagnation in the vascular network of the lower extremities. The most informative methods of examination are:

• Look at the chair. The study allows to identify characteristic changes in venous vessels in the vulvar region and on the inner surface of the thighs - ectasia, tortuosity, nodularity. Possible swelling of the labia and perineum. When viewed in the mirrors, the vaginal mucosa looks hypertrophied, cyanotic. The vaults of the vagina during bimanual palpation are smoothed, often painful.
• Ultrasound of the venous system. During ultrasound scanning, the shape and diameter of the vessels, their length, anatomical position, and the state of the wall are evaluated. The method allows to determine the branching zones, the viability of the valvular apparatus, the patency of the veins, the presence and direction of reflux. It is possible to scan both the vessels of the lower extremities and the inferior vena cava (IVC ultrasound).
• Duplex scanning of the vessels of the legs. The advantage of a non-invasive method that combines traditional ultrasound and Doppler studies is not only obtaining detailed information about blood flow parameters, but also visualizing the venous network. Duplex angioscanning is used for a comprehensive assessment of the state of superficial, perforating and deep vessels.

Radiodiagnostic methods (varicography, selective ovaricography, ascending limb phlebography, pelvic phlebography, CT venography, phleboscintigraphy, etc.) are used to a limited extent during pregnancy due to possible negative effects on the fetus. In difficult cases, if pelvic varicose veins are suspected, diagnostic laparoscopy is performed with caution. Differential diagnosis of varicose veins of the legs is carried out with dropsy of pregnant women, heart failure, lymphedema, acute thrombosis of the venous system. Varicose veins of the small pelvis must be differentiated from genital endometriosis, chronic inflammatory pathology of the pelvic organs, submucosal and subserous uterine fibroids, cysts and other ovarian tumors. In addition to the observation of an obstetrician-gynecologist, the patient is recommended to consult a phlebologist, a cardiologist, an oncologist.

Treatment of varicose veins during pregnancy

The main objectives of therapy for varicose veins in pregnant women are to stop the progression of the disorder, mitigate the severity of the clinical picture and prevent possible thromboembolic complications. Non-drug methods are considered preferable, if necessary, supplemented by pharmacotherapy in safe terms of pregnancy:

• Compression therapy. A woman with a confirmed diagnosis of varicose veins is recommended to wear daily throughout pregnancy, use elastic bandages during childbirth and the postpartum period, special compression stockings or stockings of 1-2 compression classes. Compression treatment due to the mechanical reduction of the diameter of the superficial veins allows you to accelerate blood flow, reduce swelling and congestion.
• Herbal phlebotonics and phleboprotectors. The effect of the use of drugs in this group is associated with an increase in the tone of the venous wall, a decrease in its permeability, an improvement in microcirculation, the rheological properties of blood and lymphatic drainage. The advantage of most bioflavonoids is the possibility of their use during pregnancy and lactation. Phlebotonic drugs are prescribed both in tablet form and externally.
• Anticoagulants and antiplatelet agents. If there are signs indicating a tendency to increased coagulation and the threat of developing DIC, drugs with antithrombotic activity (conventional and low molecular weight heparins) are used with caution. To improve blood rheology and vascular microcirculation, pharmaceutical agents are shown that prevent platelet aggregation and have an angioprotective effect.

Pregnant women with varicose veins are recommended special complexes of physiotherapy exercises, lymphatic drainage massage, dosed walking, daily ascending contrast shower. Diet correction involves eating foods rich in fiber and vegetable fats. Injection sclerotherapy, miniphlebectomy, crossectomy, endovasal laser coagulation and other surgical methods of treatment are used in exceptional cases in severe forms of the disease, severe pain syndrome, and the presence of complications. Most often, surgical correction is carried out at the end of the lactation period.

Delivery tactics

The preferred method of delivery for varicose veins is natural childbirth, at the beginning of which elastic bandages are applied to the lower limbs of the woman in labor or compression underwear is put on. Patients with vulvar-vaginal varicose veins require especially careful support of the pushing period with protective perineotomy performed according to indications. In case of rupture of ectatic veins, the damaged vessels are carefully ligated with repeated stitching of the conglomerate of nodes. Caesarean section is recommended for patients with a high risk of thromboembolic complications and severe vulvar varicose veins.

Forecast and prevention

With timely detection and adequate therapy, the prognosis is favorable. As a preventive measure, sufficient night sleep and periodic rest throughout the day in a prone position with legs laid on a firm surface at an angle of 30 ° are recommended. Pregnant women with aggravated heredity should stop wearing shoes with a heel of more than 5 cm, limit the time spent in a sitting or standing position, and control weight gain.

To prevent varicose veins, daily walking, reducing salt intake, and taking vitamin preparations that strengthen the vascular wall (ascorbic acid, rutin) are effective. Patients with varicose veins planning a pregnancy, according to indications, undergo surgical interventions to correct the disease.

Varicose veins is a disease of the veins, which is expressed in the expansion, lengthening, tortuosity of the veins, followed by a violation of blood flow, due to pathological changes in the venous walls and valves. Various forms of varicose veins are observed in 38% of women, and in 90% the appearance of varicose veins is associated with pregnancy. This pathology is diagnosed in 40% of pregnant women.

The first signs of varicose veins are observed already in first trimester of pregnancy.

Women complain of heaviness in the legs, fatigue when walking, the appearance of vascular networks. The dilatation of the veins that occurred at the beginning of pregnancy is constantly progressing.

The disease is aggravated by an increase in the volume of circulating blood, a growing uterus, an increase in body weight- all these factors lead to a slowdown in blood flow, an increase in pressure in the veins.

If in patients outside of pregnancy the first signs of varicose veins develop several years after the onset of the disease, then in pregnant women this process is significantly accelerated.

Clinical disease is manifested by the following symptoms:

1. Restless Leg Syndrome: a feeling of heaviness in the limbs, aggravated by a long stay in an upright position, and decreasing when resting in a prone position with legs raised up.
2. Cramps in the muscles of the leg, which occur at night in the legs covered with a warm blanket.
3. feeling hot and stagnation in the legs with a long stay in a sitting position.
4. Edema in the area of ​​the foot and lower leg.
5. A venous pattern often appears on the skin of the legs, or tortuous elastic trunks of veins appear.
6. In evening time severe itching occurs in the lower leg, mainly on the front side. The skin in these places is dry, prone to peeling.

Often varicose veins during pregnancy gets complicated, phlebothrombosis, bleeding, eczema, varicose ulcer. Itching of the skin of the legs, as a rule, precedes the formation of eczema, which, with constant scratching, leads to the appearance of a trophic ulcer.

Causes

The appearance of varicose veins in pregnant women associated with a deficiency of the hormone estrogen and an increase in progesterone. This hormonal imbalance has a relaxing effect on the vascular wall.

In addition, high concentrations of progesterone suppress hormones synthesized by the pituitary gland, which tone smooth muscle fibers.

Unfavorable factors affecting the development of varicose veins during pregnancy are an increase in the volume of circulating blood, compression of the retroperitoneal veins by the growing uterus.

Progressive weight gain with an increase in the duration of pregnancy, it affects the increase in pressure in the veins and slows down the speed of blood flow.

Photo of varicose veins

Diagnostics

A preliminary diagnosis of varicose veins is made on the basis of an external examination of a pregnant woman and her complaints. Using the methods of instrumental diagnostics, the nature of the disease is established.

The following diagnostic methods are used:

1. - a method that combines Dopplerography and ultrasound two-dimensional scanning of the veins. The procedure is performed by a special sensor in the supine position. This method allows you to obtain information about the state of the saphenous and deep veins.
2. Phlebography- X-ray contrast diagnostics based on the study of the condition of the veins using X-ray control and the introduction of a contrast agent. Allows you to identify defects and gaps in the vein, the presence of blood clots.

The main method for diagnosing varicose veins is ultrasonic angioscanning, radiopaque phlebography is used in rare cases.

Varicose veins during pregnancy on the legs: what to do?

In the first trimester of pregnancy, the treatment of varicose veins includes only elastic compression and vitamin therapy. Medications in the early stages are contraindicated, drug therapy begins in the second trimester of pregnancy.

Compression underwear

With the help of compression treatment, venous outflow in varicose veins is normalized, pathological venous emissions (reverse blood flow) are eliminated, and microcirculation improves.

Elastic compression in pregnant women with varicose veins should be applied continuously, as a result, only high quality knitwear is selected, with the help of which optimal pressure is created in the veins of the lower extremities.

Unfortunately, it is almost impossible to properly distribute pressure over the vein with elastic bandages, so their use is indicated only for short-term treatment, for example, after sclerotherapy.

During pregnancy special medical knitwear is used- tights, stockings from varicose veins of the 2nd degree of compression, and in case of a severe course of the disease - 3rd degree of compression. At the initial stage of varicose veins, when the disease is expressed by heaviness in the legs and passing swelling, it is enough to use stockings and stockings of the 1st degree of compression. More you can familiarize yourself with the choice of compression underwear.

Medical therapy

In the treatment of varicose veins during pregnancy on the legs, medications prescribed only from the second trimester of pregnancy, since many of them have contraindications for use in early gestational periods.

Use preparations of the group of phleboprotectors in tablets for oral administration and ointments for topical use.

These medicines increase the tone of the venous wall, improve microcirculation, reduce capillary permeability, prevent the development of inflammation.

Effective pills for varicose veins:

1. "" - a drug with the active substance rutin. It is necessary to apply a course of 1 month, 2 capsules per day.
2. "" - a drug of synthetic origin based on diosmin. It is used to eliminate the symptoms of varicose veins and prevent complications. It is used orally 1 tablet, a course of 1 - 1.5 months.
3. "Venarus", "" - absolute analogues based on diosmin and hesperidin. Take courses 1 - 1.5 months, 2 tablets per day.
4. "" - a solution of plant origin containing bioflavonoids and horse chestnuts. Apply inside 15 drops three times a day.
5. "" - a herbal preparation containing rutin and extracts of other plants. Apply 1 capsule twice a day.

Other drugs with anticoagulant and antiplatelet action during pregnancy are not prescribed. Their use is advisable during childbirth to prevent bleeding and thrombosis.

Creams and ointments

Tonic preparations - gels, ointments and creams for external use have a fast local decongestant and analgesic effect for the most part due to auxiliary components that have a cooling and distracting effect.

The active ingredients in most ointments are heparin and rutoside, which penetrate into the layers of the skin and have an anti-inflammatory and venoprotective effect.

These are creams and ointments:

• "Hepatrombin";
• "Venolife";

The preparations should be applied in a thin layer on the affected veins, moving from the bottom up, and then use compression stockings.

Surgical interventions

Surgery carried out with a complicated course of varicose veins- acute thrombophlebitis and phlebothrombosis.

In this case, a crossectomy is performed (ligation of the veins at the confluence of the great saphenous vein into the deep one) under local anesthesia.

With a high probability of developing thromboembolism due to the patient installing a cava filter according to the indications, an operation is performed aimed at plicating the inferior vena cava. In this case, the question of emergency termination of pregnancy is usually raised.

Read more about the methods and types of operations.

Folk methods

Gymnastic exercises

To stimulate venous outflow, it is necessary to perform the Mikulin exercise daily:

• in a vertical position, rise on toes, tearing off the heels from the floor by 1-2 cm and drop sharply. Run 30 times, rest, repeat 3 times;

Another modification of the exercise:

• perform in compression underwear: standing up, alternately raise the heels from the floor at an angle of no more than 45o, as if imitating walking on the spot, the socks do not come off the floor. Start with 10 minutes, gradually extending the exercise time to half an hour.

In the evening, after a hard day, lie on your back, raise your leg up, shake your foot slightly, perform circular motions with your foot, then do the same with the other leg. Repeat 10 times for each leg. More read about doing gymnastics.

Prevention

How to avoid varicose veins? Since the cause of varicose veins during pregnancy mainly associated with hormonal imbalance even before pregnancy. It is important to eliminate hormonal imbalance at the planning stage.

Typically, hormonal disorders in women are manifested by the following symptoms:

• mastopathy (pain in the mammary glands);
• seborrhea;
• acne;
• pain syndrome on the first day of menstruation;
• pronounced premenstrual syndrome.

If these signs are present, you should visit a gynecologist-endocrinologist before pregnancy to correct the level of hormones.

Factors that contribute to the appearance of varicose veins should also be avoided.- a long stay in an upright or sitting position, a strong weight gain (normally, weight gain during pregnancy should be no more than 15 kg), vitamin C and B3 deficiency, a large amount of animal proteins in the diet.

Prevention of varicose veins during pregnancy:

1. Spend at least 1 hour a day for walking at a moderate pace.
2. Consume plenty of fruits and vegetables, as well as juices (sources of vitamin C).
3. Rest with your legs up.
4. During sedentary work every hour - one and a half to perform Mikulin's exercise for 5 minutes.
5. Limit your intake of simple carbohydrates to prevent constipation.

The most effective prevention of varicose veins is movement, since the calf muscles physiologically work as "pumps" when walking, normalizing lymph and blood flow. You should walk 1 to 3 km daily to avoid varicose veins.

Complications

Subject to preventive measures, varicose veins during pregnancy usually do not give complications, however, the likelihood of their development is not excluded. Most of the complications occur during childbirth and the postpartum period, especially if, during the expulsion of the fetus, the woman received injuries (ruptures) of the birth canal.

When bleeding, the body starts the protective mechanism of blood clotting, as a result of which a blood clot forms in varicose veins with slow blood flow, and as a result, thrombosis and thrombophlebitis develop.

If pathological conditions occur in the postpartum period, women are prescribed antiplatelet and anti-inflammatory infusion therapy. The issue of surgical intervention is decided individually.

What is varicose veins, who gets varicose veins, and why do symptoms of varicose veins often appear during pregnancy?

The modern woman is truly unique. She learned to harmoniously combine life at an increased speed, the ability to always look good, keep up with everything and at the same time be on top, elegantly “flying” above the ground in high heels. Sometimes this leads to unpleasant consequences - the blue grid of vessels distorted by varicose veins becomes a ruthless witness to the tireless movement and frantic pace of life.

Pregnancy is a time of change. Unfortunately, often these changes are not only pleasant, but also bring a lot of grief to the expectant mother. One of these troubles that overshadows the wonderful period of pregnancy is venous insufficiency or varicose veins. In fact, a quarter of all women during their first pregnancy experience this disease. During the second and third, the risks of the disease increase.

The most prone to problems with veins are those expectant mothers who have observed varicose veins before pregnancy.

You can determine the presence of varicose veins in a pregnant woman visually: dark blue stars appear on the legs or the veins swell and become clearly visible through the skin. It is a mistake to think that this is just a cosmetic defect. In fact, varicose veins are dangerous with complications, such as thrombophlebitis, trophic ulcers. Bleeding is possible. Naturally, this is dangerous not only for the expectant mother, but also for her baby.

Symptoms of venous insufficiency

Varicose veins or varicose veins is an increase, twisting and change in the shape of the veins, occurs due to the loss of the natural elasticity of the walls of blood vessels. An unfortunate statistic says that every third woman and almost 10% of men face this problem.

The first bells that you can pay attention to are: heaviness in the legs, constant fatigue, especially towards the end of the day, itching and pain in the legs. Later forms of varicose veins are manifested by the presence of a vascular network, enlarged dark blue veins under the skin, as well as calf cramps. Advanced stages are characterized by a change in skin color in convoluted vessels, cyanosis or darkening. Also characteristic redness and dryness of the skin, a tendency to dermatitis and eczema. Severe - the last stages, in which small injuries and scratches on the legs do not heal for a long time, they bleed, ulcers begin to appear.

According to the international classification, there are six stages of chronic lymphovenous insufficiency. We have already mentioned their manifestations above, but it is interesting that in the last few years another stage has begun to be discussed - zero, both symptomatic and asymptomatic.

Varicose veins during pregnancy are the result of venous blood stagnation due to insufficient blood flow.

The initial stages of varicose veins go almost unnoticed. In the evenings after work, you may feel heaviness in the legs, swelling, and observe a slight deformation of the veins. By morning, the symptoms weaken, or disappear altogether. In subsequent stages, spasms of the calf muscles, pain in the legs, and itching may appear. Symptoms worsen at night.

When the veins are severely deformed, dilated, become oddly shaped and swell, this indicates that the disease is progressing.

What can influence the course of the disease, contribute to its development?

1. First of all, these are strong and abrupt hormonal changes in a woman's body during pregnancy.
2. Secondly, the volume of circulating blood increases.
3. Thirdly, the uterus is actively growing, the child is also gaining weight, in connection with this, the expectant mother can recover greatly, which will negatively affect the state of her veins.

For a woman, pregnancy is the main risk factor for varicose veins and the development of its inherent complications. The waiting period for a baby is associated with strong hormonal surges, in which the venous wall is very sensitive. Also, with an increase in the uterus, it begins to put pressure on the main veins, which makes it difficult for the outflow of blood. As a result, the pressure in the veins increases, which leads to their expansion. Excess weight also affects the development of varicose veins.

Varicose disease causes stagnation of lymph in the veins and edema, provokes constant intoxication and changes in the tissues of the legs, and worsens the quality of life. The negative point in this is the risk of thrombotic complications. After all, blood clots often appear both in dilated vessels and in the unchanged deep venous system.

It is this fact that requires awareness of the importance of treating venous disease during pregnancy. The rapid development of the disease is observed during pregnancy. Therefore, if you do not start treatment on time, it will be very difficult and quite expensive to achieve a good cosmetic result later.

As for the baby, the presence of varicose veins in the mother, as such, does not pose a threat to him. However, the health of the mother is extremely important for the child. Therefore, when complications occur during pregnancy and breastfeeding, and a woman needs medical or surgical treatment, babies can also be affected.

If varicose veins were diagnosed before pregnancy and you are planning to have a baby, the doctor advises all patients to undergo treatment in advance. Especially when there are changes in the stem veins and surgery is recommended. This will help to avoid complications and progression of the disease during pregnancy.

It is important for all pregnant women diagnosed with varicose veins to know the following:

1. Starting from the second trimester, you need to wear compression underwear - stockings or tights for pregnant women. The degree of compression must be determined by the doctor. So, putting them on and wearing them is difficult, but the positive impact and the feeling of comfort in the legs are worth the effort. Moreover, now you can find very high-quality and, at the same time, beautiful and sophisticated models.
2. Drug therapy is prescribed extremely rarely, only at certain stages and complications.
3. Watch your weight, try not to gain extra kilos.
4. Lead an active lifestyle during pregnancy - walk, swim, do exercises, forcing the leg muscles to work.
5. Elevate your legs to improve blood flow. Try not to sit for more than one hour. Do 5 minutes every hour if the job is sedentary.
6. Pour cool water over your legs and take a contrast shower, this will increase your tone, disperse blood, and reduce swelling.

No matter how great the speed of life is, our body, physically and emotionally, always knows what we need, when to just slow down, and when to seek the advice of a doctor. That's why:

• Listen carefully to yourself - if you have the slightest symptoms, a family history of the disease, consult a phlebologist or vascular surgeon.
• Follow the doctor's recommendations, this will protect against complications and help avoid the development of the disease, make pregnancy more comfortable.
• Always remember that most of the cosmetic defects and complaints associated with varicose veins can be eliminated with the help of a large Arsenal of modern techniques. Therefore, enjoy Pregnancy and motherhood, and phlebologists will take care of the health and beauty of your legs.

Prevention of varicose veins during pregnancy

Prevention of varicose veins during pregnancy is necessary not only for those women who have previously encountered this problem. If until now you did not know about such a disease from personal experience, this is unlikely to insure you. To prevent varicose veins, purchase compression stockings. An independent choice of this kind of product is strictly prohibited - you can purchase them only with the help of a phlebologist. He will not only help you choose the right ones, but also tell you how to use them.

Try all the methods available to you to improve the circulation of the lower extremities. In addition to moderate exercise, it is necessary to change the position of the legs often. If you are tired and have been all day, you should lie down and raise your legs to a higher level than your position. For example, if you are lying on a sofa, you can put your feet on the back of the sofa or on its protruding sides.
Go to the pool and try not to gain excess weight.

Treatment of varicose veins

Varicose veins during pregnancy can only be treated by a qualified specialist. Do not try to take on such responsibility and indulge in self-treatment. As a rule, therapy includes conservative methods, such as wearing the aforementioned stockings and physical exercises. Sometimes the doctor may find it necessary to use the gel. Today, the pharmaceutical market offers a wide range of different forms and types of drugs for venous insufficiency. But do not forget that during pregnancy most of the drugs are strictly contraindicated for you. You can only talk about local treatment, which can only be prescribed by a doctor, after weighing all the possible risks of taking the drug for you and your baby.

During internal changes, inevitable and external manifestations. Hormonal changes affect the firmness and structure of the veins, which can interfere with blood flow and cause venous insufficiency. In late pregnancy, fluid retention by the body, enlargement of the uterus, as well as the fetus, leads to compression of the veins in the legs and an increase in venous pressure.

All these factors contribute to the appearance of expansion of the nodal veins and capillaries., an increase in existing varicose veins.

Today the topic of our article is varicose veins in the legs: symptoms and treatment during pregnancy.

What is the danger of varicose veins in the legs during pregnancy?

From a medical point of view, in addition to swelling and pain caused by varicose veins, there may be even more serious problems.

Immobility of the nodal blood lines and the inevitable growth of the uterus may lead to blood clots, which increases the risk of intravenous blood clots.

Places where blood clots have formed turn red and become hard, it hurts to touch them, even a light touch of clothing can cause unbearable pain. In the case of blood clots, injections are prescribed to thin the blood. Usually, after such injections and the use of ointments, blood clots resolve within two weeks.

Reference! It is important to know that if you do not pay attention to varicose veins, and ignore the formation of blood clots, the disease can develop into a pulmonary embolism. The most common cause of death for pregnant women in developed countries is the release of a blood clot into the lungs. There are such cases in one out of 500 pregnant women.

How does the disease affect the mother and child?

The mother's heart is beating faster than usual to provide the fetus with a sufficient flow of blood, which accumulates mainly in the legs. This can lead to dizziness and fainting.

Studies show that the volume of blood vessels the size of a finger can affect the position of the baby in the womb. After childbirth, many of the dilated veins disappear, however may have poor blood clotting.

Types of varicose veins on the legs

Spider angiomas, telangiectasia. Varicose veins in the form of cobwebs or asterisks, veins, less than 1 mm in size. It is not felt to the touch, it is blue or red. Can cover the whole leg.

Mesh. Less than 4 mm in size, it is blue, purple, felt to the touch.

superficial. Easily noticeable, felt to the touch, larger than 4 mm.

Varicose veins of the great saphenous vein. The formation of balls of small or medium size in large veins, usually a greenish tint.

Deep varicose veins. Such expansion is formed by the deep intravenous system.

At-risk groups

1. The presence in the family of vascular disease or varicose veins.
2. The presence of varicose veins before pregnancy.
3. Repeated pregnancy.
4. Professions associated with a long pastime on your feet.
5. The last months of pregnancy fall in the summer.

Photo

What does varicose veins look like during pregnancy, photo below:

Causes of the disease

1. Hormonal changes in the body of a pregnant woman.
2. The growth of the fetus, which affects the insufficient outflow of blood from the pelvis to the heart.
3. Increase in blood volume, as well as fluid in the body of a pregnant woman, which is especially noticeable on the legs.
4. Curvature of the spine caused by pregnancy.
5. Multiple pregnancy.
6. Obesity, weight gain.
7. Lack of preventive measures to prevent varicose veins of the lower extremities.

Symptoms

pain. Dull pain, especially in the popliteal region. The pain usually makes the legs feel heavy. The pain increases with a long pastime on the legs, decreases when lifting the leg up.

Itching. Legs itch. A throbbing burning sensation may be felt in places where the veins are dilated, and the ankles may also itch.

Ankle swelling. Especially in the evening, mild to moderate swelling of the ankles may appear.

Skin changes on the ankles. Eczema, pigmentation, ulcers may appear.

Night cramps. Feeling tired, tense in the legs.

How to prevent the appearance of varicose veins?

1. Treat existing varicose veins before planning a pregnancy.
2. Avoid spending long periods of time on your feet or sitting.
3. Do not remain motionless for a long time.
4. Avoid sitting on low chairs.
5. Avoid hitting the sharp corners of tables, pedestals.
6. Swim regularly, walk at a moderate pace in the fresh air.
7. If you need to sit for a long time (long road in the car), you need to constantly change your position and stretch your legs.
8. Don't take a hot bath.
9. Do not stay in the sun for a long time.
10. In hot weather and after physical exertion, pour cold water on your feet, starting with your feet.
11. During sleep and rest, place the legs above the level of the heart putting pillows on.
12. As prescribed by the doctor, use pantyhose against varicose veins.
13. Avoid cross-legged posture, such a pose stops the outflow.
14. Drink more liquid.
15. Avoid salt.
16. Avoid wearing tight clothing.
17. Avoid wearing high heels.
18. Don't lift heavy things.

Diagnostics

Modern medicine can easily determine the degree and type of varicose veins. ultrasound provides duplex scanning, color display of blood flow.

If necessary, the doctor may prescribe magnetic resonance imaging, venography, or photoplethysmography- a diagnostic method that allows you to get complete information about the outflow of blood.

Treatment of varicose veins in pregnant women is carried out if it has not disappeared within two months after childbirth. Treatment starts three months after birth.

Methods of treatment of varicose veins in the legs in pregnant women

Pantyhose against varicose veins. With the appearance of thin capillaries or slightly larger veins, tights are not required. Also, with such minor formations, no drugs for internal use, both during pregnancy and during lactation, are not provided.

Usually pantyhose with appropriate pressure for the diagnosis are prescribed by a doctor. Tights help to reduce venous pressure, pain and sensitivity of the legs. Tights are put on in the morning after taking a shower and removed before going to bed.

Of course, wearing such tights is not very convenient and comfortable, especially in summer, but it's worth it, because they alleviate all symptoms. When avoiding the use of doctor-prescribed pantyhose, the consequences can be serious and difficult to treat.

Classical operation (stripping/ligation). To date, this method is rarely used, the only exceptions are those cases when varicose veins are running, and cosmetic appearance doesn't really matter. After such an operation, the hospital leaves the same day and returns to normal life after 3-4 days.

RF therapy. This method is similar to endovascular laser treatment in that a catheter is inserted into the femoral vein. However, instead of a laser, radio frequency energy is injected into the catheter to help close the dilated vessel.

Ambulatory phlebectomy. It is used when removing nodes, using a cut of 3-5 mm. It is carried out under local anesthesia. The patient is discharged 2-3 hours after the operation.

Sclerotherapy. A method for burning out arachnid varicose veins of medium-sized blood vessels. It is carried out by introducing a special preparation directly into the vein with the thinnest needle. Treatment takes 15-30 minutes.

Interesting! laser therapy. One of the most effective and painless ways to treat varicose veins. With this treatment, anesthesia is not required, usually with ice or a special cream. As a rule, varicose veins completely disappear in 3 sessions. Laser therapy is preferable to take place in the winter.

Laser therapy has varieties:

1. Exo Laser. It is used to remove arachnid small formations. Leaves no traces.
2. Endovascular laser. It is used to remove large, palpable formations. A catheter is inserted into a certain place, where the beam is directed. There are bruises for 2 weeks after the operation.
3. Endolaser. A fiber laser is inserted into the damaged vessel, which eliminates the expansion. There are no scars, but bruises remain for 10 days.

Varicose veins are a common disease, but can worsen during pregnancy. This disease easily treated with modern methods, but for this you need to wait until the end of breastfeeding so as not to harm the baby.

Pregnant women should not be upset by the appearance of their legs - this disappears if symptoms are noticed in time and see a doctor. In such cases, it is imperative to undergo a duplex ultrasound examination to determine the degree of pathology. To prevent this ugly disease, you must follow all the instructions and advice of the attending physician.

Useful video

What to do if the veins swell during pregnancy on the legs. What is the best compression garment to use.