When you are pregnant
and you are suffering from varicose veins, they are
generally harmless in the short term. They may itch
or hurt and they can be unsightly but if treatment is
needed, it can usually wait until after the pregnancy.
A small percentage of those with varicose veins,
develop small blood clots in the veins near the skin
surface. This condition is known as superficial venous
thrombosis. If this happens, the vein may feel hard
and rope-like and the area around it may be red, hot,
tender or painful. Although in most cases, these clots
are not serious, it is still wise to tell your doctor
or midwife so that they can monitor them and check
that they do not become very swollen, develop sores
or that the skin near the veins changes color. Occasionally
an infection can occur accompanied by a fever and
this would need a course of anti-biotics.
A more serious condition is called deep venous thrombosis
or DVT where clots occur in the deep veins in the
legs. Pregnancy makes you more susceptible to this
condition but it is not common. With DVT there might
be no symptoms at all or you could experience sudden,
painful swelling in the ankle, leg or thigh with a
fever. Such a clot would need hospitalization and
medication to thin the blood as left untreated, the
clot could break away and travel to the lungs causing
a dangerous condition called a pulmonary embolism.
The signs of this pulmonary embolism are shortness
of breath, painful breathing, a cough (including coughing
up blood), a feeling of panic as well as a rapid heartbeat.
You would need immediate emergency treatment.
Varicose veins often improve within 3 months of giving
birth and during this time, it is a good idea to keep
up with wearing support hose, exercising regularly,
elevating your legs and avoiding standing or sitting
for too long. However, if your veins do not improve,
become too uncomfortable or look unsightly then speak
to your doctor about the treatment options available.
Some of these are:
• Sclerotherapy – the most common treatment
where a solution is injected into the vein causing
the vein walls to swell, stick together and seal shut.
This prevents the flow of blood and the vein turns
into scar tissue, fading after a few weeks.
• Laser surgery – where very strong bursts
of light are sent onto the vein. The vein slowly fades
and disappears. This treatment is only suitable for
spider veins smaller that 3 mm.
• Endovenous Techniques – this is also
laser but can be used on the larger and deeper veins.
The doctor puts a very small catheter into the vein
which sends out laser energy that shrinks and seals
the vein wall. Healthy veins around the closed vein
restore the normal blood flow.
• Surgical ligation and stripping – where
problematic veins are tied shut and completely removed
from the leg. This surgery requires either local or
general anesthesia and is done in an operating room.
• Ambulatory Phlebectomy – where a special
light source marks the location of the vein and tiny
cuts are made in the skin and surgical hooks pull
the vein out of the leg. A local or general anesthetic
is required.
• Endoscopic vein surgery – where a small
video camera is used to see inside the veins which
are then removed through small cuts. This also requires
a local or general anesthetic.
As you can see, there are several treatment options
available and you would need to discuss with your
doctor which would be the most suitable for you.
