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Why can't I treat varicose veins during pregnancy?

This question was asked in Kempton, North Dakota and has 8 answer(s) as of 08/12/2013.
I've developed a lot of spider veins all over my legs and thighs during just the first 3 months of my pregnancy. I read though that you're not supposed to get treatment while your pregnant, why not? What will happen if I had slcerotherapy done, will it hurt my baby?


Doctors Answers (8)

The medication that is used to treat your veins has not been FDA approved during pregnancy. It is better to wait until 8 weeks after your delivery before you begin treatment.

During the pregnancy period, your hormonal levels are extremely high, as well as the pressure in your pelvic and lower extremities veins due to compression of the iliac veins by the pregnant uterus against the sacrum. This pressure decreases after delivery, thus reducing the size of the varicosities. You should wait until 3 months after lactation to address any residual varicose veins. Wear compression stockings until you're ready to see a vein surgeon.

The most commonly used drugs for sclerotherapy have not been tested for safety during pregnancy and likely never will be. Pregnancy induces a hypercoagulable state which means that the body is more prone to form inappropriate clots than in the woman who is not pregnant. Deep vein thrombosis, clotting in the veins of the muscle in the leg, is a rare event after sclerotherapy but it is a risk. Adding the small risk of DVT with sclerotherapy to the risk associated with pregnancy is not an acceptable risk except under very extraordinary circumstances. Thrombotic (clotting) complications in pregnancy can be quite severe. It may be helpful, however, if varicose veins are developing to see a vein specialist to learn about your specific clinical situation and to get you fitted properly with elastic support hose to help during the pregnancy.

You can treat them safely, but first you need to have a compete venous evaluation to establish the severity and cause of your veins.

The treatment for varicose and spider have not been tested and are not approved for pregnant women. So we just don't know that they are safe. Since spider and varicose veins are bothersome but not life threatening and we don't know for sure that they are safe, it is best to not treat spider and varicose veins when pregnant.

Sclerotherapy uses a non-toxic FDA approved sclerosant that is a medical grade detergent. In the past, women have had sclerotherapy when they did not yet know they were pregnant and there was no harm seen to the baby after delivery, and I would not expect the sclerosant to directly harm the fetus from sclerotherapy. However, there are many other reasons not to do elective treatments (including lasers) during the pregnancy as the body reacts differently due to the elevated hormone levels and modified immune responses. Also, all elective procedures have some minimal risk of a complication and the risk is compounded during pregnancy. I suggest wearing maternity compression hose on your legs during the pregnancy to minimize worsening of the problem veins and getting treatment 3-4 months after the baby is born.

There are two main reasons why spider veins and varicose veins are not treated during pregnancy in the United States. First, female hormones (progesterone) that cause veins to dilate are elevated during pregnancy and cause abnormal veins to increase during pregnancy. Some of these veins will recede after delivery, when hormones go back to normal levels. Also, blood volume is increased during pregnancy. It makes sense to wait until after the delivery to treat the abnormal veins that remain. The second reason is mediolegal. While there is no evidence that injecting spider veins during pregnancy causes harm to the fetus, the highly litigious society we live in makes treatment unreasonable during pregnancy. One final note. If you have problems with leg veins, aching, or swelling after pregnancy, get the veins treated before your next pregnancy. They will only get worse with each pregnancy, and your suffering will get worse. You do not need to wait until you complete all your pregnancies.

Firstly we recommend supportive therapy during pregnancy in the form of compression hose. During pregnancy the veins dilate to accommodate extra blood volume and if you have a hereditary pre-disposition for vein problems they can start showing up. Hose will slow down the process and your legs will feel better. There are no studies on adverse effects of sclerosing solutions on the fetus. However, I do not believe you will/should find anyone to inject solutions while you are pregnant. Likewise, we do not advise laser treatments for the same reason. Once your body has returned to normal after pregnancy and nursing, then you can be treated. Some of the veins may fade.

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