Varicose veins during pregnancy

Pregnant, put an end to varicose veins

When we are expecting a baby, our legs are strained. They swell, become heavier, are painful, and sometimes abnormally dilated veins appear under the skin: these are varicose veins. They are the expression of a chronic disease called venous insufficiency, which is characterized by a poor return of blood to the heart. The veins have “valves” to prevent blood from returning to the legs. If these fail, blood circulation slows down and blood stagnates in the lower limbs. This phenomenon distends the wall of the veins and promotes the appearance of varicose veins. Anyone can develop varicose veins, but the genetic factor is however decisive.

The risk is four times higher to be affected if one of the direct parents, father or mother, is himself concerned. And six times more when it comes to both parents. Bad luck, women are more affected by this pathology, particularly during pregnancy, a period very risky for the veins. ” From the first months, the wall of the veins can weaken under the effect of progesterone, confirms Dr Blanchemaison. This hormone, the main role of which is to stretch the uterine muscle, will also dilate the vessels. At the end of pregnancy, the phenomenon is accentuated, but this time it is the volume of the uterus, as well as the weight of the baby, which causes compression of the deep veins and thus impedes venous return. Other factors are involved, such as weight gain or the number of pregnancies. If we are expecting our second or third child, we will be more likely to have varicose veins. Pregnancy is also accompanied by other milder circulation disorders, such as varicosités. These small very superficial red or blue vessels, visible on the lower body, are unsightly marks, but not serious. They reveal a slight venous insufficiency and can remain at this stage or progress to varicose veins.

How to reduce varicose veins?

Varicose veins can appear without warning, but most of the time our body sends us warning signs. The first symptoms of venous insufficiency are manifested by pain localized in the lower limbs, a feeling of heavy and swollen legs, which we know well when we are expecting a baby. It is then necessary to apply simple measures to limit these inconveniences. To begin with, we try to stay active. Sedentary lifestyle is an aggravating factor in venous insufficiency. Just because you’re pregnant doesn’t mean you have to give up all sporting activity, and if you don’t feel like swimming or cycling, you opt for walking, which is excellent for stimulating venous return. To reduce pain, we (us or the partner) massage our legs from bottom to top, either with two cool gloves or with a decongestant cream, and we end our shower with a stream of cool water down our legs from the bottom to the top.

When pregnant, lymphatic drainage is not contraindicated, as long as it is done by hand. On a daily basis, we raise our legs when we are in a sitting position or during the night, we do not sunbathe because the heat accentuates the dilation of the vessels. The goal is always the same: we prevent the blood from stagnating in the legs, ankles and feet.. Another reflex: we favor a balanced diet and drink a lot of water. Vitamins C, E, but also mineral salts such as zinc and selenium participate in the production of collagen which our vessels need to be resistant.

Compression stockings and venotonics during pregnancy

Beyond hygiene measures, there are different types of treatment for varicose veins. The use of compression stockings is the most effective method to improve venous return and limit the risk of complications.. By compressing the muscle, ” they cause an external back pressure which will support the superficial veins and thus prevent their dilation, specifies Dr Bonnemaison. They can be worn daily, as soon as the first symptoms appear, if you are often sitting or standing. In risky situations like long journeys by plane or car, they are essential. »Compression stockings or socks are divided into three classes according to the pressure they exert on the leg. In all cases, we ask our doctor for advice, he can prescribe a model adapted to our morphology and the degree of severity of the venous insufficiency. If, despite this treatment, we still feel severe pain in the legs, we can turn to the venotonic.

These drugs restore tone to the lining of the veins and increase the speed of blood return to the heart. They are allowed during pregnancy but, ” out of caution, I recommend those which are based on plant extracts like Daflon, rather than chemical substances », Specifies the phlebologist. Venotonics are no longer covered by Health Insurance, unlike compression stockings.

Pregnant, if you have varicose veins, it is best to consult a phlebologist for a Doppler ultrasound. It is an ultrasound of the lower limbs which allows to visualize the state of the deep venous network. The specialist examines the blood flow, the condition of the veins and varicose veins. It is essential monitoring, because varicose veins can sometimes get worse. the risk of venous thrombosis, better known as phlebitis, is multiplied by five in pregnant women. This complication occurs when a blood clot blocks a vein, causing an inflammatory reaction: a hot, red and painful cord appears on part of a vein in the leg or thigh.

« We feel a sudden pain, the leg swells in the hours that follow, it can even double in size, to which is added a small fever, says Dr Bonnemaison. To diagnose phlebitis, one sign does not deceive. ” If you have a pain in the calf when you lift the tip of the foot upwards or when you walk in the attack of the step. In this case, it is necessary to consult during the day a specialist who can prescribe an anticoagulant suitable for pregnancy. The risk is in fact that the clot detaches from the wall of the veins, goes up in the lungs and causes a pulmonary embolism. It is the second leading cause of death in pregnant women in France.

Wait until the end of the pregnancy to be treated

No treatment to eliminate varicose veins is possible during pregnancy. But luckily, most of the time, these large veins naturally go away after childbirth, so you have to be patient. In general, doctors recommend waiting six months before intervening. When the varicose vein is shallow, one can opt for sclerosis or laser, the former being the less invasive method. Under ultrasound control, the doctor introduces a sclerosing product into the diseased vein in order to reduce its diameter. The endovenous laser, meanwhile, destroys the varicose vein but without extracting the vein: it is a very effective and almost painless technique.

More in a general way,if the varicose veins are not serious, it is better to wait until the end of your pregnancies before embarking on radical treatments. If, on the other hand, the veins are very diseased, surgery is strongly recommended. Performed under general anesthesia, the operation called “stripping” consists of removing the affected vein. After these treatments, regular monitoring of the venous system is necessary to avoid the appearance of new varicose veins.