Varicose Veins and Pregnancy

What are varicose veins?
Varicose veins are abnormally enlarged veins usually seen in the thigh and leg but may occur other places: technically hemorrhoids are varicose veins. In the majority of cases, these large superficial veins are of a cosmetic nuisance but they may cause symptoms. These veins connect with the deep veins of the leg and play a minor role in the transfer of blood to the heart. The veins become more prominent in the 3rd decade of life and are more common in females. Varicose veins often become more common in pregnant females. The varicose veins become more prominent during the 2nd trimester of pregnancy.

Varicose veins  in pregnancy
Varicose veins are linked to increased pressure in the veins. There are valves in the veins which prevent the back flow of blood back into the legs. When these valves become damaged/defective, the blood flows backwards and causes swelling and engorgement of the veins.

In addition, during pregnancy, there is a gain of weight and volume. Further the female sex hormone progesterone weakens the walls of the veins and making them to engorge with blood.

Where are varicose veins most common during pregnancy?
Varicose veins are generally more prominent in the legs but, they may develop near the vulva or vagina. The major reason is that the female retains a lot of weight and fluid during pregnancy. In addition, the baby in uterus may also compress some parts of the lower abdomen and lead to an engorgement of the veins in the vulva. If a female has varicose veins of the vulva or vagina during pregnancy, she will usually have varicosities of the legs at the same time.

What generally happens to varicose veins during pregnancy?
Usually, unfortunately,  the varicose veins on the legs worsen during pregnancy. The varicose veins become more prominent and start to swell. With time, the veins are engorged with blood and can cause localized pain and itching. Once the leg veins become prominent, it is unlikely that they will spontaneously resolve without any treatment. However, varicose veins on the vulva often do get better once the baby has been delivered. Most women who do develop varicosity of the leg veins will retain these varicosities after pregnancy.

Who can get varicose veins during pregnancy?
The biggest risk factor is family history. Other risk factors are obesity, prolonged standing and trauma. Varicose veins are more common in females and this has been linked to the sex hormone, progesterone. In pregnancy, varicose veins have been linked to excess weight gain and fluids. Multiple pregnancies are also associated with varicose veins. In fact, the varicosities usually worsen in size, shape and symptoms with each pregnancy.

What are symptoms of varicose veins?
Aside from being unattractive and very prominent, varicose veins of the legs cause swelling of the legs. As varicose veins progress, some females will develop discoloration at the ankles and prominent “rope like” veins along the thigh and lower leg.

How can varicose veins be diagnosed?
Varicose veins can usually be diagnosed by a simple physical examination. There is no other examination indicated. However, when the legs are involved with varicose veins, the use of Doppler ultrasound may be used to determine the presence of blood clots. This painless test assesses the valve function in the groin and can also determine how much blood is flowing back into the legs. The test can also determine the presence of blood clots in the veins.

What is treatment of varicose veins of the vulva?
There is often no treatment required for vulvar/vaginal varicosities. Once the baby is delivered, the varicosities will usually subside. In some instances, there may be a rope-like veins will remain . For those with varicosities on the vulva that remain the the treatment is always delayed until the pregnancy is over just like the varicose vein of the legs.