Varicose Veins in Pregnancy

Although they affect both men and women, varicose veins in pregnancy can be a very upsetting condition, mostly because of their physical appearance. But the condition is easily treated, as explained by Dr Ibrahim Riza, Consultant Vascular & Endovascular Surgeon at Mediclinic Dubai Mall. Here, he answers the most common questions.

What are varicose veins?

Varicose veins are abnormally dilated and highly uncomfortable or painful veins that commonly appear in the lower limbs. They can range from tiny red thread like veins, called telangiectasia, slightly larger blue thread veins, or very large and tortuous varicose veins.

Are varicose veins a ‘normal’ condition? What percentage of pregnant women will get varicose veins?

Varicose veins do occur normally. These dilated veins are a pathological condition, due to chronic increased pressure in the system of veins in the lower limbs. Studies indicate that up to 60% of pregnant women notice dilated lower limb and vulvar veins associated with leg swelling. In most cases these symptoms and signs will resolve themselves after the birth of their babies.

Why are pregnant women more susceptible to the problem?

During pregnancy the gravid uterus in the pelvis presses on the large veins in the pelvis. This causes back pressure onto the lower limb veins. If this is combined with a propensity to have leaky valves in the veins, varicose veins begin to appear. When the compression eases off (after delivery), the pressure on the back decreases and in many cases the dilated veins completely disappear. Unfortunately, in a small percentage of people, the problem persists even after delivery and they will need to have an assessment and treatment.

At what point in pregnancy do they usually appear?

Varicose veins become more pronounced during the second and third trimester.

Is the condition dangerous or life threatening? How do varicose veins affect the pregnancy? Is there a risk to mother or baby?

In themselves, varicose veins are never dangerous or life threatening. They can however cause significant debilitating symptoms like leg swelling, leg pain, inflammation and occasionally bleeding, especially of vulvar varices during delivery. There is usually no risk to the baby if the mother develops varicose veins.

Are there ways in which we can avoid getting varicose veins, or minimise them naturally?

The cause of primary varicose veins is unknown. Some people are prone to getting them and there tends to be a family history. Regular physical exercise, avoiding long periods of pressure on the lower limbs (sitting or standing), maintaining your ideal body weight and elevating the lower limbs whenever possible, can all reduce the symptoms of varicose veins. Once there is established reflux or a leak in the venous valves, therapy is needed to reduce or abolish the reflux.

What is the treatment for varicose veins – how much recovery time is needed?

The therapy for varicose veins is aimed at removing the malfunctioning vein from the circulation system of the veins so that the veins that are functioning normally are not impacted by the ‘varicose vein’. This approach is well established and all the evidence shows it provides excellent long term results.

The three main options available to remove the malfunctioning veins are:

1. Physically removing the vein with traditional surgery
2. Closing the vein with heat – commonly called laser or radio frequency ablation
3. Sealing the vein closed with medical adhesive. 

The heat and adhesive treatments are usually performed under local anaesthetic in a day-case facility. There is no need for hospital admission. Most people who undergo these procedures can return to work in 24 to 48 hours, although strenuous physical exercises should be avoided for at least a week after the procedure.

The dilated venous blemishes can also be cosmetically removed by either NdYag laser (similar to hair removal laser), or injected with a medical solution that closes these veins (injection sclerotherapy). Both these are office procedures that do not need anaesthesia and can be done during the lunch break for example.

CLICK HERE for further information on the treatments available for varicose veins and other vascular conditions.