What to do with varicose veins during pregnancy. Treatment of varicose veins during pregnancy

Varicose veins are one of the common problems that more than half of women are familiar with. Often the first manifestations or worsening of the disease occur during pregnancy. This is due to many factors: from changes hormonal levels and hereditary predisposition to the pressure of the growing uterus on the pelvic vessels. But this problem has a solution. If you know what to do for varicose veins on the legs during pregnancy, you can prevent the disease from progressing and protect both yourself and your baby from complications.

Varicose veins are characteristic only of humans; their manifestations affect the lower part of the body. This is primarily due to upright posture and prolonged stay in an upright position. A huge load is created on the veins, which have to resist gravity and “pump” blood through the venous vessels from the feet to the inferior vena cava and further to the heart. When the veins fail, blood stagnation occurs and all the ensuing consequences occur.

What are varicose veins

Varicose veins are a disease associated with deformation of the veins, most often of the lower extremities, and disruption of blood flow in them. The following points play a role in the development of the disease.

• Pathology of the venous wall. Normally, the vein wall includes muscle and connective tissue components. This ensures their elasticity and ability to resist blood flow. With sagging walls, dilated veins can no longer return to their original position. This is how “snakes” appear under the skin.
• Violation of the venous valve system. Normally, throughout the entire course of the veins, there are special valves from the inside that prevent the blood from flowing in the opposite direction. With varicose veins, disturbances occur in their functioning. As a result, the blood partially returns back under the influence of gravity.
• Changes in the functioning of the leg muscles. The muscles of the lower extremities play important role in the prevention of varicose veins. They are like an additional “pumping system”, maintaining the tone of the veins and preventing the reverse flow of blood.

It is enough to give one factor some slack, and the mechanism of varicose veins starts, which is not so easy to stop.

What triggers it?

Varicose veins are very insidious. Unnoticed by a person, it can progress for years until its manifestations lead to serious complications. Pregnancy is a period when all organ systems are under maximum tension, often at the end of their own capabilities. Therefore, at this time, varicose veins often appear for the first time, or the woman notes a significant progression of the disease.

Main factors during pregnancy

It is important to understand that if the problem was noticed during pregnancy, it has already existed for more than one year. The following factors can be called provocateurs of varicose veins during pregnancy.

• Growing uterus. Already from the 2nd trimester, the uterus occupies most of the space in the pelvis. This leads to compression of blood vessels and nerve endings. As the period increases, the outflow of venous blood from the lower extremities worsens, it begins to be deposited in already altered veins and provoke expansion of others. It is during pregnancy that women often encounter varicose veins in the groin or in intimate places (in the clitoris, labia majora and minora).
• Increased blood volume. The appearance of the second circle of blood circulation (in a child) and the need to provide nutrients developing fetus lead to an increase in circulating blood volume. The load on the vessels increases. If there is a predisposition to varicose veins or the initial stage of the disease, the veins begin to expand and the blood in them begins to stagnate.
• Gestagens. A necessary condition For normal course pregnancy is a sufficient level of progesterone. It creates conditions for the growth and development of the fetus in the uterus. At the same time, progesterone relaxes smooth muscles - in the intestinal wall, bronchi, uterus, and also in blood vessels. This leads to the fact that the veins lose their elasticity, cannot resist the increased blood flow and become varicose.
• Decreased activity. During pregnancy, women do not lead such an active lifestyle as before. Especially with increasing gestational age, when a large belly gives additional stress. Muscle work is extremely important for the prevention of varicose veins: their contractions additionally push the blood upward, preventing reverse flow.

Other reasons

The following points also influence the progression of the disease.

• Heredity. In women with a tendency to varicose veins, the disease develops and progresses faster. As a rule, a thorough examination reveals a connective tissue defect. Therefore, the walls of the veins, consisting of it, even under the slightest load, are subject to varicose changes. In such women, one can note long fingers and toes, increased flexibility, and a tendency to sprain the ligaments. They are often diagnosed with various types of thrombophilias (disorders of the blood coagulation system), frozen pregnancies at different stages.
• Working conditions. At risk for developing varicose veins are women who, due to their occupation, have to stand on their feet for a long time. These are sellers, hairdressers, doctors.

How does the disease manifest itself?

Many women believe that they know the main symptoms of varicose veins during pregnancy, meaning dilated and thickened veins. But the clinical picture is much more varied; it begins to appear long before varicose veins are visible to the eye.

Signs of the disease largely depend on the stage. Varicose changes can affect not only the veins of the lower extremities, but also the external and internal genital organs. The main cause of genital varicose veins during pregnancy is the growing uterus.

The clinical manifestations of varicose veins on the legs are known to many, but not everyone associates its initial conditions with impaired venous outflow. There are five stages of disease development.

1. "Tired Leg Syndrome" There is a feeling of heaviness and aching in the legs in the evening, frequent night cramps, tingling along the veins that are still normal, multiple spider veins. If varicose veins are in the groin, the woman feels nagging pain in this area.
2. The appearance of modified veins. Over time, the woman notes that the veins in her legs, which were previously barely noticeable, swell and protrude. Most often, vessels appear on inner surface shins, in the popliteal fossa, on the labia. Over time, they turn into “balls of snakes.”
3. The appearance of swelling of the legs. As the disease progresses, swelling of the lower extremities becomes difficult to resolve after a night's rest.
4. Change in skin color of legs. In the final stages of the disease, when due to constant stagnation of blood in the lower extremities, tissue nutrition is disrupted, darkening (hyperpigmentation) of the skin occurs. It takes on a brown tint. When palpated, tubercles are determined along the entire limb.
5. The appearance of trophic ulcers. The last stage is characterized by the appearance of ulcers that heal very poorly - months, even years. Such a manifestation of varicose veins is typical after 20-30 years of development of the disease, and is extremely rare in pregnant women.

Classification

In practice, phlebologists more often use the definition of varicose veins by stage and CEAP (international classification). Gradation according to ICD-10 (international classification of diseases from 2010 revision) does not reflect the severity of the disease and is used only to encrypt the disease in documentation.

The following codes for varicose veins according to ICD-10 are distinguished:

• I83.9 - varicose veins without complications;
• I83.1 - varicose veins with symptoms of inflammation or dermatitis;
• I83.0 - varicose veins of the lower extremities with the presence of ulcers;
• I83.2 - damage to veins with deep tissue changes (with both ulcers and inflammation).

The CEAP classification is a more detailed coding of the disease. It takes into account certain symptoms, causes, anatomical location of altered vessels and pathophysiological aspects of the disease. Next to each letter (CEAP) there is an additional number that indicates the severity of the symptoms.

• "WITH" . Indicates the stage of development of the disease. For example, if the index is “0” - there are no visible manifestations, “1” - there are telangiectasia - “asterisks”, “2” - single varicose veins.
• "E". Encodes the cause of the disease. For example, hereditary predisposition, after surgery or unknown etiology.
• "A" Indicates which parts of the veins are affected by varicose veins. For example, only superficial ones or together with deep ones.
• "P" Defines other changes. For example, is there reverse blood flow, blood clots.

Will the disease go away on its own after childbirth?

Some women believe that signs of varicose veins during pregnancy will go away on their own after childbirth. However, one should not hope for the complete disappearance of the disease. Many provoking factors will go away (hormonal levels, pregnant uterus), so the symptoms will become less noticeable. Varicose veins of the labia, vagina and groin (if there were any) will go away, but the disease itself will continue to progress if treatment is not started in time.

It is important to remember that varicose veins last for years. If you don’t pay attention to it immediately after giving birth, after 10-15 years a “bouquet” of problems is guaranteed.

What are the dangers of varicose veins during pregnancy?

It is not varicose veins themselves that are dangerous during pregnancy, but the complications that can develop. Their likelihood increases closer to the 3rd trimester.

Blood clots

Stagnation of blood in altered veins provokes a change in its properties. Increased risk of blood clots, especially in later. They can migrate to other organs, causing serious changes. All this can lead to PE (pulmonary embolism), infarction of brain structures.
The likelihood of such complications increases on the eve of childbirth and immediately after it. Therefore, at this time it is especially necessary to pay attention to the prevention of the disease.

A blood clot formed in the lower extremities can be accompanied by inflammation - thrombophlebitis occurs. This often occurs during pregnancy. Main manifestations:

• the affected leg swells;
• the vein is painful when touched;
• the skin over it is red and hot;
• the vein itself is dense to the touch.

If such symptoms occur, you should immediately seek medical help. This condition increases the risk of more serious thrombosis (pulmonary artery, femoral and inferior vena cava), which can have negative consequences for the fetus and mother.

Bleeding from nodes

The skin over varicose veins is often thinner and more easily injured. The walls of the vessels themselves are overstretched. Even the slightest injury leads to vein rupture and severe bleeding.

When the altered vessels are localized in the genital area, the likelihood of such a complication increases during childbirth. In addition, bleeding from varicose veins difficult to stop. A regular compression bandage does not always help; special sutures often have to be applied.

How to confirm the diagnosis

In order to find out whether varicose veins during pregnancy are dangerous for a child and a woman, it is important not just to state the fact of the disease, but to establish all the accompanying disorders. Sometimes mild varicose veins can be accompanied by thrombosis of the central vessels and pose a real threat. All pregnant women with varicose veins need to undergo blood clotting tests more often in order to timely monitor the likelihood of blood clots.

To clarify the stage of the disease, the following methods are used.

• Functional tests. They were relevant in diagnostics at a time when ultrasound was not yet so widely used. Today they can be used to preliminary assess the severity of the disease and confirm/refute assumptions. The essence of one of the simple functional tests is as follows. In a lying position with legs elevated, the large saphenous vein in the thigh area is pinched with a finger. Then, in a standing position, the blood flow of the superficial veins of the lower limb is studied. Normally, they should be asleep within 15-20 seconds, after which they fill with venous blood. If this happens faster, it means there is a pathological discharge of blood and failure of the valve system.
• Ultrasound examination. Ultrasound of the veins helps not only determine the functioning of blood vessels, but also the presence of blood clots in them. For more information, use various techniques, most often this is Doppler ultrasound (study of blood flow speed).
• X-ray phlebography. The essence of the method is to inject contrast into the veins and take x-rays to study the route of the substance. It is not carried out during pregnancy due to possible harmful effects on the fetus.

Principles of treatment

During gestation, the complex of all therapeutic measures is minimal. Surgical interventions are carried out only in extreme cases. The main treatment for varicose veins is carried out after pregnancy. The principles of treatment of the disease during pregnancy are as follows.

• Gymnastics for legs. Without waiting for the progression of the disease starting from the 1st trimester, you should engage in physical activity in doses. Hiking, swimming in the pool, doing yoga - all this will improve blood flow in the legs. It is useful to perform special gymnastics, especially for women with professional risk of varicose veins. The exercises are simple but effective. For example, you need to rise on your toes and lower yourself. At the same time, the calf muscles work, which prevent blood from stagnating in the deep veins.
• Body weight control. Every extra kilos will increase the volume of circulating blood and the load on blood vessels. Therefore, it is important for pregnant women not to exceed 12-15 kg for the entire gestation period.
• Wearing comfortable shoes. During pregnancy you should not wear high heels. Optimally - no more than three to five centimeters.
• Using compression garments. Elastic compression is one of the important areas of treatment. There is special underwear (stockings, tights, knee socks) for pregnant women, where special inserts have been developed for the growing belly. Compression garments provide dosed external pressure to the entire limb. Moreover, it is maximum at the ankle, and minimum at the hip. This stimulates the directional movement of blood. The choice of compression garments should be taken seriously. It is best to purchase it in consultation with your doctor. Only a specialist can determine whether preventive or therapeutic products are needed. It is necessary to wear such stockings or tights throughout the entire period of gestation and always during childbirth and postpartum period. Reviews from doctors confirm the fact that compression garments are the most effective remedy prevention of varicose veins during pregnancy.
• Drugs to improve blood properties. In case of severe varicose veins and a complicated medical history (for example, with thrombophlebitis in the past), venotonic agents, for example, Detralex, can be prescribed at the discretion of the doctor. Many medications for varicose veins are prohibited during pregnancy. For example, "Trental", "Ginkor-forte".
• Local medications to prevent complications. To reduce the symptoms of varicose veins during pregnancy, it is allowed to use gels and ointments. For example, "Lioton 1000", "Heparin". You can start using them as early as early stages.

When is surgery necessary?

Surgery and subsequent rehabilitation for varicose veins during pregnancy are resorted to in extreme cases. This is due to many factors. But the main thing is that during the gestation period it is impossible to carry out radical treatment, since pregnancy itself aggravates the condition and somewhat blurs the clinical picture.

Surgical interventions are performed in cases where the life of the woman and the fetus is at risk. For example, when blood clots form in the lower extremities with a high risk of rupture and further migration. In such situations, it is recommended to install vena cava filters - special “meshes” in the inferior vena cava, which stop blood clots on their way.

Folk remedies

All folk remedies should be discussed with your doctor. Such treatment at home is best carried out against the background of basic recommendations.

• Apple cider vinegar. It is recommended to wipe the skin over varicose veins with a vinegar solution.
• Nettle infusion. This herb has a complex effect. For varicose veins, it is recommended to use an infusion. To prepare, you need to take two tablespoons of crushed nettle leaves, add hot water and simmer in a water bath for 30-40 minutes. Store the prepared solution in the refrigerator for no more than a day. Take half a glass twice a day.
• Green tomatoes. It is recommended to apply unripe homemade tomatoes to the affected veins overnight in courses of 10-14 days.
• Sour milk. The lower limbs should be lubricated with homemade sour milk and wrapped in a bandage overnight. Helps relieve fatigue and swelling.

Prevention measures

Every woman who has the disease or is prone to it should know how to avoid the progression of varicose veins during pregnancy. The recommendations are as follows:

• move more;
• perform self-massage of the feet;
• wear compression stockings or tights;
• sleep with the leg end raised;
• use ointments with heparin, horse chestnut (Lioton 1000).

Varicose veins of the lower extremities often occur during pregnancy, especially in women predisposed to the disease. Surgical treatment of varicose veins during pregnancy is carried out only for health reasons. The main measures are to prevent the progression of varicose veins, expressed in taking medications approved during pregnancy (tablets, ointments), wearing compression garments and maintaining physical activity.

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Almost a third of women during pregnancy experience such an unpleasant phenomenon as.

The appearance of swollen veins in the legs not only causes a lot of inconvenience, but can also cause serious health problems.

This is why you should not let this condition worsen: What to do if varicose veins appear on the legs during pregnancy?

Most women first encounter varicose veins during pregnancy. This is facilitated by the constant growth of the uterus, which compresses the iliac veins, causing the blood vessels to suffer: their tone decreases, the walls become less elastic and blood circulation worsens.

Most often, varicose veins affect the lower extremities, but the disease can also appear in the pelvic organs, and in some cases even affect the uterus and vagina.

There are several reasons that may increase the risk of varicose veins in the legs during pregnancy:

• changes in the general hormonal background of a pregnant woman;
• hereditary factor (very often the weakness of the venous vessels is congenital and inherited through the female line);
• wearing high-heeled shoes (during pregnancy you should completely avoid such models);
• heavy physical activity;
• work that does not allow frequent changes of body position (sedentary or, conversely, requiring prolonged standing);
• excessive consumption of sugar and refined foods;
• and obesity;
• Chronic diseases the pregnant woman has.

It is also necessary to take into account the fact that each subsequent pregnancy increases the risk of varicose veins by almost half.

Also, this disease often accompanies women suffering from hepatitis or cirrhosis of the liver.

Signs

Varicose veins occur as a result of impaired blood circulation and decreased tone of the venous network.

Often this condition is accompanied by pain in the lower extremities, fatigue and the appearance of edema.

Women with this disease cannot stand on their feet for a long time; sometimes even a simple walk becomes a very difficult ordeal. To avoid such a problem, it is necessary to begin treatment of varicose veins on time and follow the measures recommended for the prevention of this disease.

You should consult a doctor if the following symptoms appear:

• pain in the legs (not only in the feet);
• heaviness and increased fatigue when walking or standing for a long time;
• the presence of swollen veins that clearly appear under the skin;
• (especially in the evening);
• red or blue-violet veins on the legs;
• spider veins;
• during night sleep.

All these symptoms are quite conditional and can mean not only the appearance of varicose veins, but also the occurrence of other pregnancy pathologies that require medical care. In any case, only a doctor can assess the severity of symptoms and make an accurate diagnosis.

Stages of the disease

• First (initial) stage.

This is the period when the disease is just beginning to manifest itself, however, it already causes a lot of unpleasant sensations for the pregnant woman.

The initial stage is characterized by the appearance of slight swelling, a feeling of heaviness and pain in the legs.

The woman begins to notice that it is difficult for her to stand on her feet for a long time and walk long distances. Among the visual signs, expectant mothers note:

• slight blue discoloration of venous vessels;
• the appearance of barely noticeable stars;
• enlarged veins in the legs.

Rarely, in the first stage, a burning sensation may be noted in the calves and feet.

• Second stage.

At this stage, all the signs characteristic of the initial stage of the disease remain.

In addition to all these symptoms, the expectant mother may for the first time notice the appearance of leg cramps, which can be quite painful. Also, pain can now appear directly in the veins, which practically does not occur in the initial stage of varicose veins.

• Third (final) stage.

Severe varicose veins on the legs, brought to stage 3, almost always require surgical intervention, and can lead to very serious consequences for the health of a pregnant woman.

Distinctive features of the disease at stage 3:

• appearance age spots on your feet;
• changes in the color and structure of the skin;
• cracks on the legs;
• very strong bulging of venous nodes.

Varicose veins in the legs at this stage are dangerous because any mechanical damage (trauma, pinching of the skin) can lead to the venous nodes beginning to burst, forming ulcers.

Successful drug treatment of varicose veins is possible only at stages 1 and 2 - the final stage of the disease often ends with surgery to remove diseased veins.

Varicose veins are quite dangerous for a woman’s health, as they can cause thrombophlebitis and bleeding, both during childbirth and in the postpartum period.

In addition, due to blood flow disturbances, the contractility of the uterus may deteriorate - this is fraught with disruption of labor and the use of stimulant drugs. Therefore, it is extremely important not to accelerate the course of the disease and adhere to the following recommendations:

• Eliminate high-calorie foods containing large amounts of fat and simple carbohydrates from your diet.

This measure is necessary to control the weight of a pregnant woman, since it is excess kilograms that provoke the strengthening and development of varicose veins.

• Limit the consumption of salt, spices, herbs and marinades.

These products promote fluid retention in tissues, which can result in swelling or worsen swelling.

• It is recommended to do special therapeutic exercises several times during the day.

A set of exercises is selected individually by a phlebologist, taking into account the severity of the disease and the health status of the pregnant woman.

• Swimming is also recommended for expectant mothers with varicose veins.

It is advisable to visit the pool at least twice a week. This will help improve blood circulation and avoid stagnation.

• Required use.

Medical knitwear can be purchased at pharmacies or orthopedic salons. These can be socks, knee socks, stockings or tights (depending on the location of the diseased veins). This underwear will have to be worn not only during pregnancy, but also during childbirth.

• Be sure to change your body position as often as possible throughout the day and lie with your legs raised high (at least 10 minutes).

Treatment of the disease in pregnant women

The main principle when choosing a drug for the treatment of any disease in pregnant women is the absence of a negative effect on the fetus.

Any medications to get rid of varicose veins are prohibited for use in the 1st trimester, as the most important body systems of the unborn baby are being actively formed.

Starting from the 2nd trimester, the doctor may prescribe treatment for varicose veins on the legs if the woman’s condition requires it.

This is usually done by a phlebologist specializing in diseases of the venous vessels, but if there is no such doctor in the city (for example, in a small town), the pregnant woman is monitored by an obstetrician-gynecologist and a local therapist.

Tablets used for varicose veins

Preparations in the form of tablets (phlebotonics), prescribed to pregnant women diagnosed with varicose veins, have a tonic effect on the veins, and also strengthen the venous walls and improve blood circulation.

The most famous of them:

• "Detralex";
• "Venoruton";
• "Ginkor Fort".

Ointments for varicose veins of the lower extremities

Ointments and gels for the treatment of varicose veins are topical agents. They are divided into three groups, each of which has a different degree of impact and the result obtained from use.

Heparin-based ointments

Medicines for varicose veins, which include heparin, have a complex effect on the affected areas:

• relieve swelling;
• prevent the formation of clots and blood clots;
• reduce blood clotting.

Heparin-based ointments are the optimal choice for the treatment of varicose veins during pregnancy. Most often, expectant mothers are prescribed the following drugs:

• Heparin ointment;
• "Lioton 1000";
• "Dolobene";
• "Hepatrombin-C".

Gels and ointments containing plant substances

They are more gentle compared to heparin-based drugs; despite this, they are quite effective in the fight against varicose veins. Can be used for a long time.

The effect of their use occurs quite quickly, which makes these products very popular among pregnant patients.

The main effect of such drugs:

• reduce the permeability of the walls of venous vessels;
• improve the elasticity of blood vessels;
• restore damaged areas.

• "Venitan";
• "Cycleven";
• "Girudoven."

Anti-inflammatory nonsteroidal drugs

They are used as part of complex therapy for diseases, relieve pain and inflammation in the affected areas. They have a partial antihistamine effect. These products include topical gel “Diclofenac” based on menthol. It quickly relieves inflammation, relieves itching and burning and helps reduce the intensity of pain.

Indomethacin ointment, which is also often prescribed to women during pregnancy, has similar properties.

What drugs should not be taken during pregnancy?

Glucocorticoid hormonal medications, which are very effective in treating varicose veins on the legs, are contraindicated for pregnant women.

They have a powerful effect and can quickly cope with the problem. However, such drugs have a large number of contraindications for use during pregnancy, as they have a negative effect on the fetus and can affect the course of pregnancy. Among them are such tools as:

• "Flucinar";
• "Sinaflan";
• "Lorinden";
• "Celestoderm".

Treatment of varicose veins on the legs using traditional methods

Foot baths with medicinal herbs can be quite effective in the fight against varicose veins.

• It is necessary to prepare a herbal decoction of chamomile, calendula, thyme or sage.

To do this, brew a handful of herbs with boiling water, let it brew for about 10 minutes and strain through a sieve. Add the resulting broth to a bowl of warm water (about 35-36 degrees). Keep your feet in the resulting mixture for 15 minutes, then do a light massage. To improve the result, you can lie down after the procedure with your legs raised up.

• You can also use compresses made from hop cones.

Moisten gauze or a piece of thin cloth folded in several layers with infusion of hop cones. You can prepare it yourself or buy it ready-made at the pharmacy. Apply the compress to the affected area for 20 minutes.

If cramps occur, you can prepare horse chestnut tincture. 50 g of chestnut must be poured with 250 ml of vodka and left for three days. Rub your feet with the tincture every day before bed.

Some women are helped by applying a paste of apples (preferably sweet and sour) or tomatoes to the affected areas. It is recommended to repeat this procedure every day for at least a week.

Prevention: what to do to prevent the onset of the disease?

The most important rule that must be followed to prevent the development of varicose veins is to reduce the load on the legs.

Preventive measures will help with this, because it is much easier to prevent the disease. Pregnant women should:

• refuse uncomfortable or tight shoes, as well as high-heeled models;
• control weight;
• remove from your wardrobe during pregnancy stockings, knee socks and tights with tight elastic bands that tighten the lower limbs;
• It is advisable to accompany each shower with contrasting douches;
• during night sleep, it is advisable to lie on your left side to relieve the pressure of the uterus on the vena cava;
• periodically change body position throughout the day;
• avoid chairs and armchairs with low seats;
• do not sit cross-legged;
• monitor proper digestion and avoid constipation.

Varicose veins do not pose a danger to the baby, but can cause serious health problems for a pregnant woman. Therefore, under no circumstances should the course of this disease be allowed to take its course. If it so happens that the disease makes itself felt during pregnancy, you must immediately contact your doctor, because the successful outcome of therapy largely depends on the time of initiation of treatment.

Varicose veins- swelling of peripheral subcutaneous vessels, characterized by the formation of nodes and destruction of the valve apparatus. Due to this, the reverse flow of blood to the heart is disrupted. Most often, varicose veins affect the veins of the lower extremities, but pathology can be observed in the vessels of the pelvis, abdominal cavity and other parts of the body.

Varicose veins during pregnancy are one of the most common complications of the gestation period. This disease can cause severe complications - thrombophlebitis, trophic ulcers, bleeding. That is why, if signs of varicose veins appear, the expectant mother should begin treatment.

Causes of varicose veins

Varicose veins are a multi-stage pathological process. In the first stage of the disease, the valves of blood vessels lose their function, due to which there is a slowdown in the return flow of blood to the heart. This phase of the pathology is reversible and can last for several years.

When blood flow disturbances persist for a long time, formed elements - leukocytes - begin to settle on the inner wall of the vein. They provoke an inflammatory reaction, leading to dysfunction of the vessel.

Changing the shape of the valve causes blood to stagnate and stretch the vein wall. Due to this, pathological nodes are formed in the vessel. Overstretching injures the vein wall and leads to the migration of fluid from the blood into the surrounding space, causing swelling.

The reasons for the development of varicose veins during pregnancy may be the following factors:

1. Changes in the amount of hormones in the blood. With the onset of pregnancy, progesterone synthesis increases in the female body. This hormone is necessary to maintain the gestation process. However, progesterone has a relaxing effect on the smooth muscles of hollow organs, including the vascular wall. Due to hormonal shifts, the lumen of the veins expands, so they cannot fully pump blood to the heart. Stagnation of fluid in the vessels provokes stretching of the wall and the development of nodes.

2. Increased vascular pressure. In the first trimester of pregnancy, changes are observed in the circulatory system of the expectant mother, leading to changes in rheological properties. The intravascular fluid becomes less viscous, this measure is necessary to improve the blood supply to the fetus. However, changes in blood properties lead to an increase in venous pressure, causing the development of nodes.

3. Increased platelet activity. Towards the end of pregnancy, the expectant mother's body begins to actively prepare for childbirth. During the birth of a baby, a woman can lose a lot of blood. This is why platelet activity in her body increases in the last trimester of pregnancy. If a woman has the initial stage of varicose veins, these changes in the rheological properties of the blood will worsen the situation.

4. Decreased activity of the expectant mother. While carrying a baby, a pregnant woman tries to avoid increased physical activity. A sedentary lifestyle impairs the performance of veins, causing stagnation of blood in them.

5. Hereditary predisposition. Varicose veins can occur due to genetic disorders in the structure of the vascular wall. Pathologies of collagen and smooth muscle metabolism cause blood stagnation and the appearance of nodes.

Types of varicose veins

Most often, expectant mothers encounter varicose veins in their legs. This phenomenon is due to the fact that the vessels of the lower extremities overcome the greatest resistance on their way to the heart. Varicose veins on the legs can develop over a long period of time without causing clinical symptoms.

The next most common is varicose veins of the labia, groin or pubic area. Typically, this pathology is observed during repeated pregnancies. According to studies described in the article “Varicosis of the labia: diagnosis, treatment and prevention”, in 30-60% of cases the disease disappears on its own after childbirth.

Even less often, pregnant women experience varicose veins of the small pelvis - pathologies of the uterus and its cervix. This group diseases is associated with hereditary predisposition. Also, varicose veins of the pelvic organs are observed in the presence of foci of chronic inflammation, previous abortions and surgical interventions.

Hemorrhoids are a separate group of varicose lesions. The disease develops in half of pregnant women, its appearance is associated with an increase in the size of the uterus. The organ compresses the intestines, causing constipation and stagnation of feces. This process contributes to varicose hemorrhoidal veins.

What to do if varicose veins occur on the legs during pregnancy:

Signs of varicose veins

For a long time, varicose veins may not appear clinical picture. The first signs of the disease are the following symptoms:

• veins acquire a more pronounced relief and bright color;
• development of the “vascular network”;
• swelling of the lower extremities or groin area in the evening;
• feeling of heaviness in the lower extremities or groin area;
• unpleasant discomfort in the perineal area;
• itching in the legs or intimate area.

Severe varicose veins are accompanied by more pronounced symptoms. The expectant mother may complain of pain in the affected area. With varicose veins of the lower extremities, a pregnant woman experiences discomfort in the calf muscles, as well as their cramps.

Over time, dark blue veins with a tortuous shape and nodes are observed on the lower extremities or in the groin area. As the pathological process develops, swelling may not subside by morning. Varicose veins of the uterus or its cervix are not accompanied by clinical symptoms. In rare cases expectant mother may notice pain in the lower abdomen.

Diagnostics

Diagnosis of varicose veins is based on the patient’s life history, his complaints and the results of a clinical examination. At the appointment, the doctor conducts a visual assessment of the affected area, and the specialist also palpates the vessels. When varicose veins are present, the veins have a dense consistency and irregular shape.

To clarify the diagnosis and assess the extent of the pathological process, specialists may prescribe an ultrasound scan with a Doppler sensor. This study visualizes the condition of the vessels, their diameter, and wall thickness. Doppler scanning also helps determine the state of blood flow in the affected veins.

If necessary, the expectant mother is prescribed a computed tomography and radionuclide study. These diagnostic methods are potentially dangerous for the child’s body, so their use is possible only if there are vital indications.

Traditional methods of treatment

Before using any traditional methods The expectant mother should consult a doctor. Taking some medicinal plants may provoke negative reactions from the woman and the fetus.

One of the most famous folk remedies for varicose veins is taking a decoction of nettles. The plant helps improve the functioning of veins; it also contains healthy vitamins and microelements.

To prepare the drink, the expectant mother should take 2 tablespoons of the dry extract of the plant and pour half a liter of boiling water over it. The resulting liquid should be allowed to stand for an hour. It is recommended to drink a nettle decoction one-third of a glass an hour after meals.

Another folk remedy for treating varicose veins is an infusion of Antonov apples. To prepare it, the expectant mother should take 2-3 small fruits and pour a liter of boiling water over them. It is recommended to leave the resulting liquid for 4 hours, and then take half a glass of it on an empty stomach.

People also use a garlic-honey mixture to get rid of varicose veins. Pregnant women are advised to use this method with caution, since the products are strong allergens.

For cooking folk remedy the expectant mother needs to take 250 grams of garlic and 350 grams of honey and mix them in a bowl. The resulting mass should be infused for at least ten days. Garlic-honey mixture is consumed one tablespoon 30 minutes before meals.

Non-drug treatment

Changing your lifestyle is one of the factors in getting rid of varicose veins. The expectant mother should engage in feasible physical activity, stimulating the functioning of the vascular system. Allowed sports include swimming, walking, and light gymnastics.

It is also recommended that the expectant mother reconsider daily diet. Eating salty, spicy, smoked, canned, fried foods can provoke an exacerbation of varicose veins, so a woman should avoid them. The diet should consist of fresh fruits and vegetables, lean meat, cereals, fish, eggs, and brown bread.

Compression garments are designed to treat veins in the groin area. Special clothing improves the return flow of blood to the heart. Anti-varicose stockings are used in the treatment of vascular pathologies of the lower extremities.

Drug treatment

The safest medications for varicose veins during pregnancy are topical medications. Medicines in this group include ointments, creams and gels.

Venoruton gel is an analogue of vitamin P; the drug affects cellular metabolism. Medicine increases venous tone, reduces swelling in soft tissues, and also eliminates pain. The medication can be used from the first trimester of pregnancy.

Heparin ointment reduces the intensity of thrombus formation and prevents the development of wall clots. The drug also contains an anesthetic. This medicine should not be used by persons with trophic ulcers. Expectant mothers can use heparin ointment from the beginning of pregnancy.

Gel Lyoton 1000 is intended to prevent the formation of blood clots and inflammation of the veins. The drug prevents the development of complications of varicose veins. The drug is allowed to be used from the early stages of pregnancy.

Attention! If you experience discomfort, heaviness, itching, swelling in the legs or groin area, as well as if you observe bright visible veins in these areas, the expectant mother should consult a doctor.

If there are indications, the expectant mother should use complex therapy, including local and systemic drugs. General medications improve the rheological properties of blood and increase the resistance of the venous wall.

Detralex, available in tablet form, has a venotonic effect. The drug reduces the distensibility of blood vessels and reduces congestion. The drug strengthens capillaries and increases blood return to the heart. Detralex does not cause an increase in congenital anomalies of the fetus, so it can be used at any stage of pregnancy.

Curantil tablets contain Dipyridamole. The drug is used as a prophylaxis against blood clots. The drug also strengthens the venous wall and prevents the development of varicose veins. If indicated, the medication can be used during the entire period of pregnancy.

Prevention

If the recommendations are followed, the expectant mother can avoid the development of varicose veins in the legs and groin area. To prevent the disease, a pregnant woman should lead an active lifestyle. Hiking, calm dancing and gymnastics, and swimming in the pool are encouraged. Also, the expectant mother should not engage in heavy sports - training with weights, cycling, horse riding.

To prevent varicose veins of the lower extremities, doctors recommend wearing compression tights. In the third trimester of pregnancy, expectant mothers should wear a prenatal bandage.

To prevent varicose veins of the lower extremities, a pregnant woman should avoid wearing high-heeled shoes. Also the expectant mother It is not recommended to sit for several hours in a row, cross your legs, or stand for a long time.

To prevent varicose veins, a pregnant woman needs to exclude harmful foods from her diet - smoked, fried, spicy and salty. The expectant mother should eat foods rich in vitamins and minerals. The diet should include vegetables, fruits, berries, meat, fish, cereals, eggs.

Varicose veins and childbirth

The presence of varicose veins of the legs has virtually no effect on the birth process. However, during contractions and pushing, the expectant mother should wear special stockings or bandages. Ignoring this rule can provoke complications of varicose veins - inflammation of blood vessels and blood clots.

Sometimes, in order to stabilize the condition, a few weeks before the birth of the baby, a woman is recommended to undergo a course of treatment with anti-varicose veins. If there are serious indications, the expectant mother undergoes surgical delivery by cesarean section.

You have probably heard about such a disease as varicose veins. It is associated with persistent irreversible expansion of the veins and, as a result, disruption of normal blood flow. Varicose veins are most often observed in the lower part of the body - on the legs, on the genitals, in the pelvis. One of the favorable factors for the occurrence of such changes is pregnancy. Of course, this does not mean that if you become pregnant, you will definitely encounter this disease: only half of women experience varicose veins during pregnancy. If a woman has suffered from it before, then while carrying a baby the disease will most likely begin to progress.

Varicose veins during pregnancy develop as a result of changes in the body of the expectant mother, the structure of her body and a change in the woman’s lifestyle. There are some specific factors that provoke the appearance of this disease:

1. Hormonal changes. During pregnancy, the level of progesterone increases, which relaxes the muscles of the uterus, but it also has “ side effect": relaxation of the walls of blood vessels. As a result, the ascending veins cannot actively pump blood, stagnation begins, which contributes to even greater dilation of blood vessels - a vicious circle!
2. Increased venous pressure– blood in pregnant women becomes more fluid. This is necessary to improve blood supply to the fetus. But this is not so good for the veins: they become permanently dilated.
3. Increased blood clot formation- this is how the body prepares for childbirth so that the woman does not lose too much blood after the placenta separates. But, if varicose veins have already begun, the tendency to thrombosis will only worsen the situation.
4. Decreased level of physical activity– Pregnant women often prefer to lie down rather than perform some kind of gymnastics. However, if there are no contraindications, gymnastics must be done! Or take long walks. All this improves blood circulation and serves as a prevention of varicose veins.

Types of varicose veins during pregnancy

By the way, varicose veins happen various types. Consider those that occur most often during pregnancy:

• varicose veins during pregnancy in the groin - the appearance of swollen veins in the groin, the woman feels “bloating” in this area;
• varicose veins of the uterus during pregnancy are the result of a hereditary predisposition and increased work of the iliac veins. It can also occur as a result of prolonged inflammatory processes, abortions, failure menstrual cycle etc.;
• Vaginal varicose veins during pregnancy are a fairly common form of the disease, which especially often affects women whose mothers and grandmothers suffered from enlarged veins in the legs;
• and finally, varicose veins on the legs are the most common form of this disease.

Treatment of varicose veins

Not all methods used to treat varicose veins can be applied to women in an “interesting situation.” For example, sclerotherapy (injections of special drugs) and surgery– radical, but also the most effective methods are strictly contraindicated for pregnant women. They should not be used even if a woman plans to become a mother within the next two years, because then a relapse of the disease is practically unavoidable.

Therefore, the only remedies for varicose veins during pregnancy that certainly will not harm anyone are to the expectant mother, nor the baby - wearing compression garments (special stockings and tights) and various topical products (creams, ointments). If we talk about the latter, then products based on heparin (Lioton-gel) and horse chestnut extract (preparations such as Dr. Theiss, Venitan, etc.) have proven themselves well. If your doctor recommends that you wear compression stockings or stockings, be prepared to wear them during childbirth - at this time the risk of developing thrombosis increases significantly.

How does childbirth occur with varicose veins?

Varicose veins are not at all a contraindication to bearing and giving birth to a baby. You just need to be more careful about your health. The doctor will suggest prevention of thrombosis and inflammation of the veins. The question will also arise about how to give birth - natural or by caesarean section. You will decide this together with your gynecologist and phlebologist. If possible, natural childbirth is always preferred. But before giving birth, you will definitely wear compression stockings or bandage your legs with elastic bandages to prevent the backflow of blood during labor.

Do varicose veins go away after childbirth?

By the way, many are interested: if during pregnancy the doctor diagnosed “varicose veins,” then what to expect after childbirth – recovery or, conversely, an aggravation of the situation? No one, not even your attending physician, will give you a definite answer to this question. It all depends on the characteristics of your body. Some women after giving birth forget about what varicose veins are (at least for a while), while others continue to suffer and look for ways to eliminate this problem. So, how are varicose veins treated after childbirth?

Today, medicine can offer 2 ways to treat varicose veins: conservative – with the help of medications and operational – by surgical intervention.

After childbirth, women often develop, in addition to varicose veins, venous thrombophlebitis, inflammation of the vein walls, and venous thrombosis. The symptoms are usually the same: tension of the veins, painful sensations when palpated, redness of the skin on the affected area of ​​the body, up to an increase in temperature. If you observe all these unpleasant phenomena in yourself, immediately contact your doctor and be prepared for him to prescribe hospitalization for you.

Now you need bed rest, and most of the time your legs should be in an elevated position. If we talk about drug treatment during this period, in such cases sulfonamides, antibiotics, anti-inflammatory drugs and, if necessary, painkillers are usually prescribed. Sometimes doctors fight the problem with the help of coagulants - drugs that prevent blood clotting. There is one peculiarity: they can be taken no earlier than 3 days after birth to avoid uterine bleeding.

Prevention of varicose veins during pregnancy

As always, preventing a disease is much easier than treating it. Therefore, every woman needs to know about measures to prevent varicose veins during pregnancy, regardless of whether she has a predisposition to this disease.

If neither you nor your family have ever encountered such a problem, you do not spend all day on your feet and you do not have excess weight– preventing varicose veins will not be difficult. If all these “aggravating” factors are present, then preventive measures you need to resort to it with double diligence: it really gives very good results.

By the way, remember that each subsequent pregnancy increases the risk of the occurrence and development of varicose veins.

If you notice that swollen venous “nodules” (even very small ones) have appeared on your legs, go to a phlebologist or surgeon: the doctor will monitor you throughout your pregnancy and for some time after childbirth.

How to avoid varicose veins during pregnancy

Let long (at least 2 hours) walking walks around the city will become your daily habit. This is a good warm-up for the calf muscles, and blood circulation improves significantly when walking. But in extreme heat it is better to stay home.

Another great option - swimming: this and physical activity, and a kind of water massage. It is also useful because it has a beneficial effect on the spine, which experiences increasing stress as your tummy grows.

You will also find it useful contrast shower, only the temperature difference should not be too large, otherwise you may feel ill (not because of varicose veins, but simply because of “ interesting situation"). Be guided by your feelings.

Be careful when choosing shoes. None high heels ! If there is a heel, then it should be low (no more than 3-5 cm) and stable. It should not have elastic bands, ties or laces that squeeze and tighten the leg - this interferes with blood circulation. The same goes for tight elastic socks.

Try periodically throughout the day lie down for 15-20 minutes with your legs elevated. Have you seen in films how Americans sit with their feet on the table? We consider this unacceptable, but what an excellent prevention of varicose veins! Of course, you don’t have to put your legs on the table, but on a soft pillow is the way to go.

Get used to it sleep only on your left side: This relieves the pressure of the uterus on the vein that is on the right side and reduces the venous pressure in the legs. Try placing a small pillow under your stomach, it is very comfortable.

For the prevention of varicose veins during pregnancy, and just for wellness, try to distribute the time during the day that you spend in the “standing-sitting-lying” positions. Any extremes are unacceptable: you should neither walk to the point of exhaustion, nor lie on the couch for 10 hours straight.

Do not sit with your legs crossed, especially on a low seat.

Varicose veins on the legs during pregnancy occur in every third woman. This disease is not only accompanied by unpleasant symptoms, but can also lead to serious complications that pose a threat to the health of the mother and child. To avoid the dangerous consequences of varicose veins during pregnancy, a woman should pay close attention to the manifestations of the pathology and try to eliminate it in a timely manner.

Causes

Many women first encounter varicose veins of the legs during pregnancy. Even those expectant mothers who did not have problems with the veins of the lower extremities before pregnancy are at risk of developing vascular pathology. This is facilitated by a number of factors associated with natural changes in the body of a woman carrying a baby.

Experts identify the following causes of varicose veins on the legs during pregnancy:

• Increased progesterone levels. Changes in hormonal levels in the first months of gestation, which are aimed at preserving the fetus, affect all vital systems female body, including the circulatory system. The blood thickens, stagnation occurs, the walls of blood vessels become loose and weakened and cannot withstand pressure. All this leads to varicose veins.
• Increased load on the circulatory system. During pregnancy, a woman’s blood circulation begins to work in an enhanced mode, ensuring the normal functioning of two organisms at once: mother and child. The load on the veins increases, which provokes the appearance of the first symptoms of varicose veins.
• Pressure from the growing uterus. The occurrence of varicose veins in late pregnancy is most often due to the fact that the uterus and the child (having last months gestation, heavy weight) begin to compress the pelvic veins. This causes poor blood circulation and vascular pathology.
• Increase in body weight. The more kilograms a woman gains during pregnancy, the greater the load on the veins of the lower extremities, the higher the risk of developing varicose veins in the legs. The situation gets worse many times over if the expectant mother is obese.

It has also been noted that varicose veins occur more often in women with placenta previa and in those who constantly suffer from constipation during pregnancy - all this disrupts blood circulation in the vessels of the pelvis and lower extremities and increases intra-abdominal and venous pressure.

How varicose veins appear on the legs

A pregnant woman may suspect that she has varicose veins of the lower extremities even at the initial stage of the disease. The expectant mother may often be bothered by swelling, heaviness and bursting pain in the legs, especially in the late afternoon. These symptoms indicate the onset of stage 1 of the disease.

A clear sign of the transition of varicose veins to stage 2 is the appearance of small venous networks of bluish or purple color on the surface skin limbs. In addition, with stage 2 disease, the veins in the legs are clearly visible. In addition to pain and heaviness in the lower extremities, numbness and cramps in the calf muscles may be added.

A severe form of varicose veins is characterized by severe swelling of the veins, a constant feeling of pain and fatigue in the legs, morning and evening swelling.

How and with what to treat

The treatment of varicose veins during pregnancy must be taken responsibly. In no case should the manifestations of the disease be ignored, but the expectant mother should not treat varicose veins on her own either. During this period, it is extremely important, together with a specialist, to select effective and safe methods treatments that do not affect the development of the child and the gestation process.

The best results during pregnancy are achieved by complex therapy for varicose veins of the legs, including the use of compression garments, medications, and traditional medicine and performing recreational exercises.

Compression jersey

To get rid of varicose veins during pregnancy and prevent the development of complications, the expectant mother needs to start using it at the first signs of the disease. This will help reduce the load on the vessels, improve blood circulation, tone the walls of the veins and reduce the manifestations of pathology.

During pregnancy, it is allowed to wear compression socks, stockings and leg warmers. The appropriate degree of compression is selected by a phlebologist. Most often, a woman with varicose veins in the legs has to use medical knitwear throughout pregnancy.

Drugs

Drug treatment of varicose veins of the legs in the 1st trimester of pregnancy involves the use of drugs for external application. Most topical antivaricose drugs are absorbed into the blood in minimal quantities and do not have a harmful effect on the fetus, so they can be used without fear in the early stages of pregnancy. During pregnancy, it is allowed to use Lyoton, Venolife, gel.

If indicated, in the 2nd and 3rd trimester, as prescribed by a doctor, you can take tablets with an angioprotective effect. Drugs such as Phlebodia, Detralex and Venarus will help cure varicose veins.

Traditional methods

With the permission of a specialist, you can use it during pregnancy for varicose veins of the legs. It is best to use recipes intended for external treatment. It is not recommended for pregnant women to use herbal infusions and decoctions internally, as this can adversely affect the process of bearing a child and the development of the fetus.

During pregnancy, it is allowed to make baths, rubs, ointments and compresses based on wormwood, hop cones, calendula, and chamomile.

How to avoid

Preventing varicose veins of the legs during pregnancy is much easier than curing the disease. Already from the first trimester, a woman should prevent pathology by adhering to the following recommendations:

1. Throughout pregnancy, wear compression garments selected by a phlebologist, avoid uncomfortable shoes and tight clothing.
2. Avoid prolonged standing or sitting.
3. If there are no contraindications, engage in feasible physical activity, take daily walks, and do gymnastics.
4. Sleeping on your left side improves blood flow.
5. Give preference to healthy foods and monitor weight gain.
6. From the 2nd trimester of pregnancy, wear a bandage.

Following these simple rules does not guarantee complete protection against varicose veins of the lower extremities, but significantly reduces the risk of developing the disease during pregnancy.

What threatens

In itself, vascular pathology of the veins does not harm the development of the fetus and the course of pregnancy, but it should be remembered that varicose veins are dangerous due to complications that can affect both the child and the mother.

The effect of varicose veins on the fetus

A serious consequence of varicose veins in the legs is.

This is an inflammatory disease in which there is an increase in blood viscosity and the formation of blood clots in the vessels (blood clots on the wall of the vein). Negative changes occur not only in the lower extremities, but also in the area placental blood flow, which can lead to pathologies of fetal development and fading of pregnancy, especially if thrombophlebitis occurs in the early stages. The disease is also dangerous due to the detachment of a blood clot, leading to the death of mother and child.

Childbirth with varicose veins

In most cases, childbirth with mild to moderate varicose veins occurs naturally without complications. Throughout the entire labor process, women need to wear compression stockings. If varicose veins are advanced, a cesarean section may be indicated for a pregnant woman.

In some women suffering from varicose veins, childbirth is complicated and leads to bleeding and the development of thrombophlebitis.