Varicose Veins During Pregnancy

Roughly two in every five pregnant women will experience varicose veins during their pregnancy.¹ There’s certainly a lot to keep track of when you’re expecting, and your vascular health is no exception. In this article, we discuss why varicose veins form during pregnancy, what you can do about them, and what to expect after you’re done expecting. We also discuss your vein treatment options in the rare event that your pregnancy veins stuck around afterwards.

Varicose Veins

Varicose veins are blood vessels that have become large and twisted due to insufficient blood flow. Usually, varicose veins are discussed in the context of the legs but are also common in the vaginal area and the buttocks during pregnancy.³ Varicose veins can be accompanied by noticeable swelling throughout the leg and various pain patterns including aching, throbbing, heaviness, or tingling.

Varicose Veins & Pregnancy

For two in five women that develop varicose veins during their pregnancy, 70-80% of them first experience symptoms within their first trimester.⁴ If you’re reading this early in your pregnancy, the bad news is that vein symptoms tend to worsen as you get closer to term. This observation has been attributed to a few important physiological changes that occur with pregnancy:

1. When pregnant, your estrogen levels are elevated (along with other hormonal changes), and this dilates the veins to enhance circulation.
2. If this isn’t your first pregnancy, your vein structure may have weakened due to previous long-term stress on your veins.
3. The pregnant uterus puts extra pressure on the inferior vena cava. This is the vein that carries blood from your legs back to your heart.
4. Pregnancy sees an increase in blood volume throughout the body. This increase adds extra pressure within the veins.

Unfortunately, three criteria can make you more susceptible to the formation of varicose veins during your pregnancy.^5-6

1. If you have given birth before, you are 50% more likely to develop varicose veins during your next pregnancy.
2. The older you are, the more likely you are to develop varicose veins during your pregnancy. Women aged 30 to 34 are 1.5 times more likely to develop varicose veins than women under 30; women aged 35 and older are 4 times more likely.
3. If you have a family history of vein disease, you’re also more likely to develop varicose veins during pregnancy.

Preventing Varicose Veins During Pregnancy

Even if the odds aren’t in your favor, there are steps you can take to reduce your chances of developing varicose veins or at least reduce the severity of your vein symptoms. These methods aren’t guaranteed to prevent varicose veins, but they have been shown to reduce the likelihood of developing them.³

• Immerse your legs in water: When you are in the water, the external water pressure helps to move blood upwards from the legs and reduce leg swelling.
• Wear graduated compression stockings: These stockings are tight around the ankles and loosen as they go up the leg, which helps blood flow back to the heart.
• Massage your feet: A massage can help distribute any fluid buildup outside of your vessels, which reduces swelling and pressure.
• Rest on your left side: This minimizes the pressure on the vena cava, a major vein in your pelvic region.
• Elevate your legs: This helps blood flow back to your heart.
• Light exercise: Routinely flex your feet and stretch your calves to help push blood out of your legs.

VARICOSE VEINS AFTER PREGNANCY

Typically, varicose veins that develop during pregnancy improve on their own within 3 to 4 months after giving birth. However, if they were present prior to the pregnancy, they will typically persist, or in some cases, worsen into a more advanced stage of chronic venous insufficiency.²

Because varicose veins tend to go away after a pregnancy, it is not advised to seek vein treatment unless your symptoms persist for at least 4 months afterwards, or the severity of your vein symptoms increases. In the event that you are experiencing troubling symptoms – aching, cramping, swelling, itchiness, or restless legs – you should consult a vascular specialist. Varicose veins can typically be evaluated with a brief ultrasound exam and treated with a simple minimally invasive procedure.

ABOUT THE AUTHOR

Dr. Aaron Fritts is a practicing vascular and interventional radiologist with Interventional and Vascular Care in Dallas, TX. Dr. Fritts is passionate about helping individuals with vein disease and other vascular conditions. In addition to patient care, Dr. Fritts is the founder of the BackTable Podcast, an educational platform for practicing vascular and interventional specialists.

REFERENCES

[1] Rabhi, Y., Charras-Arthapignet, C., Gris, J.-C., Ayoub, J., Brun, J.-F., Lopez, F.-M., … Dauzat, M. (2000). Lower limb vein enlargement and spontaneous blood flow echogenicity are normal sonographic findings during pregnancy. Journal of Clinical Ultrasound, 28(8), 407–413.

[2] Dindelli, M., Parazzini, F., Basellini, A., Rabaiotti, E., Corsi, G., & Ferrari, A. (1993). Risk Factors for Varicose Disease Before and During Pregnancy. Angiology, 44(5), 361–367.

[3] Smyth, R. M., Aflaifel, N., & Bamigboye, A. A. (2015). Interventions for varicose veins and leg oedema in pregnancy. [Review][Update of Cochrane Database Syst Rev. 2007;(1):CD001066; PMID: 17253454]. Cochrane Database of Systematic Reviews, 10(10), CD001066.

[4] Carr SC. (2006). Current management of varicose veins. Clin Obstet Gynecol. 49(2):414–26.

[5] Vuylsteke, M. E., Thomis, S., Guillaume, G., Modliszewski, M. L., Weides, N., & Staelens, I. (2015). Epidemiological study on chronic venous disease in Belgium and Luxembourg: Prevalence, risk factors, and symptomatology. European Journal of Vascular and Endovascular Surgery, 49(4), 432–439.

[6] Dindelli, M., Parazzini, F., Basellini, A., Rabaiotti, E., Corsi, G., & Ferrari, A. (1993). Risk Factors for Varicose Disease Before and During Pregnancy. Angiology, 44(5), 361–367.