Pregnancy and Varicose Veins
PRE-PREGNANCY
Most women do not suffer from venous symptoms before pregnancy. The arterial system in a normal person is a high pressure and high energy system. The normal venous system is a low pressure and low energy system. This state allows for blood and its waste products to be transferred from the higher pressure system to the lower pressure system on the cellular level. When one of these states is diseased; a loss of pressure in the arterial system or an increase in pressure on the venous system; complications can arise. During pregnancy increased pressure from the fetus and all of the internal changes on the iliac veins in the abdomen and pelvis. This increased pressure along with hereditary disposition can cause damage to the valves in the venous system, resulting in complications that left untreated can become severe.
VENOUS INSUFFICIENCY
The human heart and the arterial system provide nutrient rich blood to all the cells in the body. It does this by the contraction of the heart muscle and the contraction of the medial layer of the arterial wall. The result is your pulse. The blood returns to the heart by a different system; the venous system. Blood flows back to the heart in the venous system two ways. The first is normal breathing. Each time you take a breath the pressure in the your abdomen increases and decreases; this pressure change pulls the blood into the abdomen and into the heart through the normal respiratory cycle. The second way to provide venous return to the heart is through muscle contraction. The calf of your leg is essentially the heart of the venous system. When the muscles contract the blood is pushed up the veins. One way valves in the veins prevent the flow back down the leg during periods of rest. The body has three times as many veins as it does arteries, and when the veins are working correctly provide excellent venous return. Gravity is working against the venous system increasing the hydrostatic pressure in the veins. When the valves become damaged or do not work correctly the venous flows in the wrong direction and is called venous insufficiency.
VENOUS INSUFFICIENCY AND PREGNANCY
The increased pressure in the pelvis during pregnancy causes increased pressure on the iliac veins. This increased pressure can cause the valves to not work correctly and results in venous insufficiency. Like children, pressure always finds the path of least resistance. The path of least resistance in veins are the branches of the main superficial venous system. As the pressure in the veins increases the size of the veins increases. The size of the vein increases causing more valves to not work correctly, resulting in a systematic failure of the venous system. The result is a high pressure venous system that can’t remove waste products effectively causing swelling, pain and visually distended veins or varicosities.
PREVENTION
Graduated medical compression garments have been used for years to aid the venous system. Maternity compression pantyhose are made to fit comfortably around the abdomen and provide graduated compression from the foot to the waste. The compression provides support to the venous system against the increased pelvic pressure and aid in the fight against gravity. One should wear light compression 8-15 mm Hg or 15-20 mm Hg at the beginning of pregnancy when the venous system is still healthy. Ask your physician what compression is best for you.
TREATMENT
Often with pregnancy everything is changing around the Mother, that the last thing that is of her concern is own leg health. It may only be noticed when the problems have already became obvious. In the case of severe edema she may be advised to elevate her legs and to wear maternity pantyhose of a higher compression. A physician will be able recommend the right compression based the symptoms presented. After pregnancy along with medical compression there are several advancements in the treatment of venous insufficiency.