Pregnancy and Varicose Veins: Can I Prevent Them?

Mark A. Edelman, MD, DABVLM, is a board-certified physician specializing in venous insufficiency. He is the lead physician in Center for Vein Restoration locations in Norwalk and Stamford, Connecticut.

A significant risk factor for the development of venous insufficiency is pregnancy, particularly multiple ones. Both the hormonal effects of pregnancy and the weight of the enlarged uterus containing the growing fetus contribute to the development or worsening of venous insufficiency. Venous insufficiency is when the valves in the leg veins malfunction and don’t allow blood from the limbs back to the heart where it belongs. Blood can then flow backward and collect (pool) in the legs.

In my experience as an in-clinic specialist in venous insufficiency, I have seen many patients with worsening swelling, cramping, varicosities, and skin changes during their pregnancy.

The Effect of Pregnancy on the Lower Body

Hormonal changes and increased blood and body fluid volume during pregnancy can put tremendous pressure on the veins and lymphatic vessels in the pelvis and lower body, causing pain and discomfort.

As pregnancy progresses, fluid finds it harder and harder to defy gravity and go back up toward the heart. As a result, you may start seeing swelling (edema) in your lower extremities, and varicose veins develop in your legs. Varicose veins are enlarged, gnarled, sometimes painful veins that can appear on the legs.

Although treatment options during pregnancy are obviously limited, I do see these patients in the clinic to exclude the presence of an underlying blood clot (known as deep vein thrombosis or DVT). While extremely rare and usually not even evaluated unless the patient has significant leg swelling or a hard, tender vein, it is recommended that you let your health care provider know if you develop rapid or serve swelling anywhere in your body during pregnancy.

Maternity Compression Stockings

During the consult with a pregnant patient, we can measure her for maternity-sized compression stockings. These will minimize the damage to the vein valves from the evolving venous insufficiency, in addition to helping the patient’s leg symptoms improve.

Benefits of maternity stockings

Maternity compression stockings are designed to be snugger at the feet and ankles and looser as they go up the legs. This gentle squeezing of the lower body reduces the diameter of the blood vessels in the legs, improving the vessels’ ability to push the blood back up to the heart. Wearing compression stockings during pregnancy can:

• Reduce ankle swelling
• Relieve aches and pains
• Decrease risk of varicose veins

The growing uterus during pregnancy obstructs venous blood flow out of the legs, resulting in sustained high pressure in the veins, which causes them to stretch and become varicose veins. By supporting lower legs and ankles with compression stockings during pregnancy, blood and lymphatic vessels are protected from getting overwhelmed.

Vein Treatment Post-Pregnancy

Six weeks following delivery, I ask the patient to return for a complete venous evaluation and possible treatment. Although there is often improvement following delivery of the baby, it is important to correct any underlying venous insufficiency. The purpose of this is twofold: to provide complete symptom relief in the present and minimize the damage from possible pregnancies in the future.

Schedule an Appointment with Dr. Edelman

Call 1-800-FIX-LEGS or visit centerforviein.com for more information about the causes and treatments for vein disease. Most major insurances are accepted, including Medicare and Medicaid.