Presented by Brigham and Women's Hospital

What You Need to Know about Varicose Veins During Pregnancy

Pregnancy is an exciting time, but fluctuating hormones and a changing body can cause some discomforts. A common complaint is varicose veins, which may first appear during pregnancy – or at least become more pronounced.

Why varicose veins may develop during pregnancy, and who is at risk

There are several theories as to why pregnant women often develop varicose veins. As the uterus expands to accommodate a growing baby, it can put pressure on your pelvic veins and the inferior vena cava (the vein that carries blood from the lower extremities to the heart), resulting in obstructed blood flow. Another theory is that hormonal changes might cause blood to pool in the legs. Heredity can also play a part.

Just because you’re pregnant doesn’t mean you will develop varicose veins or other vein conditions. Women who have had previous injuries and pregnancies, and those who are overweight are at increased risk. “You can inherit a genetic predisposition for varicose veins from your mother or father or even grandparents,” says Dr. Marie Koch, an interventional radiologist and vein care specialist at Brigham and Women’s Vascular and Vein Care Center. “The more of these risk factors a person has, the more likely they will develop varicose veins.”

What you can do before and during pregnancy to prevent varicose veins

“Varicose veins can’t be completely prevented, but improving circulation and muscle tone in your legs can reduce the risk of developing varicose veins or getting additional ones,” says Dr. Koch. If you’re planning a pregnancy or are already pregnant, you can take the following preventive measures to reduce your chance of developing varicose veins.

  • Exercise regularly to improve leg strength and muscle tone. This will help blood move through your veins. If you’re already pregnant, talk to your doctor before beginning exercise.
  • Avoid standing or sitting for long periods of time without a break.
  • Don’t cross your legs when seated.
  • Keep your legs elevated when you’re sitting, resting or sleeping.
  • Lose weight if you are overweight or obese. Extra weight puts more pressure on your veins.
  • Don’t wear tight clothing and consider wearing compression stockings if your doctor recommends them.

How and when to treat varicose veins

“The varicose veins that develop during pregnancy often disappear or improve within a few months to a year after delivery, when the vascular and hormonal changes of pregnancy resolve,” says Dr. Koch. Wearing compression stockings during the day is usually considered before other treatments for varicose veins. If symptoms don’t improve, a vein specialist may suggest a procedure such as endovenous laser treatment. “Your doctor inserts a thin tube (catheter) into an enlarged vein, and laser energy is used to close the varicose vein,” she says. It’s a minimally invasive outpatient procedure that is often combined with ambulatory phlebectomy, which removes large-surface varicose veins through a series of tiny skin incisions that cause minimal scarring.

Sclerotherapy, another treatment option, involves injecting the veins with a solution that scars and closes the veins. “There is no surgical incision needed, and most patients find any discomfort to be minimal.” However, because the procedure involves injections of a solution into the circulatory system, Dr. Koch does not recommend sclerotherapy while breastfeeding.

Other vein conditions that may occur during pregnancy

In addition to varicose veins, other vein conditions can develop during pregnancy, including superficial thrombophlebitis (a blood clot in a vein close to the surface of the skin) or deep vein thrombosis (a blood clot which forms in the deep veins of the leg). “Deep vein thrombosis (DVT) is a serious condition and it’s important to recognize and treat it as soon as possible,” says Dr. Koch. Symptoms of DVT include swelling, pain, tenderness or skin redness.

Choosing a vein treatment program

Patients should look for programs with board-certified vein specialists which are accredited by the American College of Radiology and the Intersocietal Accreditation Commission. Brigham and Women’s accredited Vein Care Centers in Newton, Foxborough and South Weymouth offer the latest advances in minimally invasive treatment for varicose veins, performed by our experienced team of board-certified interventional radiologists,

For more information about varicose veins and how they may affect your pregnancy, contact Brigham and Women’s Vascular and Vein Care Center.