What is it?
Hormonal changes during pregnancy, premenstruation and menopause can lead to the walls of veins become distended, due to weakened valves. Once they weaken, the effect is bulging veins from under the skin, which is commonly referred to as varicose veins.
In pregnancy varicose veins are most commonly seen in the legs and genitals (such as the vulva, labia, rectum and perenium). This is because of increased blood volume in the body that is needed to be passed to the baby via the placenta, and the weight of the baby and placenta bearing down on the blood vessels below the abdomen. One vein in particular, the inferior vena cava vein that runs down the right hand side of the body, has a lot of pressure on it as it carries the blood from the lower limbs and organs back to the heart.
Overweight women, women who are pregnant with multiple babies and women who have had varicose veins in previous pregnancies are most susceptible to developing them.
What are the symptoms?
In some cases, the only symptom of varicose veins is the visibility of the veins themselves, but pregnant women can also experience:
- Itching and discomfort on the skin above the veins
- Swollen feet (fluid accumulation)
- Muscular cramps
- Skin conditions such as eczema or ulcers (in extreme cases
- Spider veins or broken capillaries
How is it diagnosed?
Varicose veins will most likely be obvious to doctors and the pregnant women who have them, but doctors may also want to feel the veins to see how hard they are and if they are occurring in conjunction with any fluid retention because both these things can be a sign of blood clots.
For genital varicose veins, an ultrasound could be given to determine how extensive they are, and sometimes X-rays to check for blood clots, too.
What's the treatment?
Most women will find that their varicose veins subside a few weeks or months after their pregnancy ends, although some women could need surgery, injections or laser treatments to reduce them. Varicose veins tend to worsen with each pregnancy though, so treatment is usually not given until a woman has finished having children, unless there is a more urgent problem.
If a woman develops minor blood clots in varicose veins just under the skin, treatment with antibiotics and blood thinning injections is sometimes necessary
During pregnancy, the best way for women to prevent and manage varicose veins is to:
- Sleep on the left to try and take some strain off the inferior vena cava vein
- Keep legs elevated as much as possible, do pelvic floor exercises and move and change positions continually throughout the day to encourage good circulation and take pressure off the inferior vena cava vein
- Wear compression stockings to stop swelling and provide support to the skin around the varicose veins
- Eat a diet low in salt to keep fluid retention to a minimum
Does it affect the baby?
Varicose veins do not affect the baby directly, but certain associated problems such as Deep Vein Thrombosis (DVT) and superficial thrombophelbitis can, although they rarely occur.
DVT is when blood clots form in the veins, and because pregnancy encourages blood to clot more easily as a safeguard against bleeding in the uterus, it increases the risk of DVT. Superficial thrombophelbitis is when a blood clot just under the skin swells and causes inflammation.
The main way DVT and thrombophelbitis can affect the health of an unborn baby is when the health of the mother is compromised first, so if veins seem to be hard, swollen or inflamed, women should speak to their doctors immediately. Women should also be aware of new aches and pains in the legs, and discuss with their healthcare provider.
Facts verified by Dr Andrew Zuschmann. Dr Andrew Zuschmann is a Miranda-based fertility specialist, obstetrician and gynaecologist.