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What can I do about my varicose veins during pregnancy?

This question was asked in Cleveland, Ohio and has 6 answer(s) as of 02/24/2015.
I am pregnant and have varicose and spider veins on my left leg. I already had some before I got pregnant, but they are getting worse more quickly. Is there anything I can do to stop it from getting worse without surgery? Would it be better to wait until after I give birth to be treated, if needed? I am worried that a treatment like Asclera would harm the baby.


Doctors Answers (6)

Pregnancy can greatly accelerate the development of problem veins including varicose veins, reticular veins, spider veins and hemorrhoids. There are multiple factors for this, including a 50 percent increase in the maternal circulating blood volume, hormone driven relaxation of the joints and connective tissues (to assist the natural delivery), and an increased weight and pressure of the uterus over the large vein returning blood from the legs back to the heart. I would recommend wearing maternal style leg compression hose to support the legs and increase venous return starting at the earliest point possible in the pregnancy. Elective procedures including sclerotherapy should wait until at least three months following the delivery. The chemical sclerosants such as Asclera are medical grade detergents and are non-toxic, but will produce a local vasculitis and the response of the body to injury is altered during pregnancy. As a rule, ALL elective procedures during a pregnancy should wait until after delivery plus some time to return to a normal state.

Graded compression stockings 20 - 30 are what I use for my patients. Check with your doctor for a recommendation. They really help with leg cramps, swelling and aching. Your legs must be measured for the right size.

During pregnancy we recommend only compression stockings or pantyhose, leg elevation and staying moving instead of standing in one spot. We do not recommend surgery or sclerotherapy until after the baby is born.

Varicose and spider veins often get worse or appear during pregnancy. The hormones dilate the vein. After the first pregnancy these may subside. Subsequent pregnancy can increase the veins again and may not resolve. During pregnancy we recommend support therapy. Today compression hose are much lighter and more easily tolerated. I will start my patients on 20-30 mmHg pressure graduating to 30-40 mmHg in the late second trimester. These should be measured and fitted by a certified fitter. Purchase as good brand such as Sigvaris or Bauerfeind. Less expensive fabrics are not usually as comfortable. It is individual choice if you go for thigh length or pantyhose. Thigh length is usually better tolerated and easier to get on. We advise against any treatments during pregnancy or breast feeding. Allow time for hormones to return to normal and then seek an evaluation from a board certified vascular trained surgeon who specializes in treating varicose veins.

The best solution for you is compression stockings, and to avoid surgery at this time. Asclera is not the best choice for varicose veins; it is usually reserved for smaller spider veins.

During the time that you are pregnant and for around six weeks afterwards, you are considered hypercoaguable or prone to getting blood clots. During the pregnancy, all I would recommend is using compression hose. I would not recommend any treatments while pregnant. Asclera is considered category C in pregnancy. This generally implies it is not tested in humans, but is not safe in animal studies on fetuses. I would wait for six weeks after having the baby. Some of the veins that you have will improve post partum. Some may remain.

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