Varicose veins. Symptoms and treatment in women during pregnancy on the legs. What stockings to wear, how to smear, exercises

Phlebeurysm (from the Latin "varix" or "varicis" - "bloating") - a disease of the blood vessels, in which there is an expansion of superficial veins lower extremities, hemorrhoidal, parametric (around the uterus), ovarian venous plexuses, as a result of which blood flow.

What is varicose veins (varicose veins)

The pathology of the veins develops due to the failure of the blood vessels, in which the venous walls lose their elasticity and become thinner. The diameter of the lumen in them increases, aneurysm-like local expansions are formed, and valvular insufficiency develops.

At the initial stage, varicose veins are not particularly dangerous, but rather a cosmetic defect. However, without proper treatment, the disease can quickly break down and lead to thrombosis. At risk are women during pregnancy, the elderly and those who suffer from cardiovascular diseases.

Causes of occurrence

The process of varicose expansion begins due to deformation of the venous walls and disruption of the venous valves.

The usual scheme for the development of the disease looks like this:

1. vascular walls lose elasticity, become weaker;
2. ascending vessels stretch and become wider;
3. the valves, which are supposed to prevent the backflow of blood, cannot block the entire lumen;
4. blood, which should be pumped up, partially goes down;
5. stagnation forms in the veins of the lower body;
6. the blood presses on the walls of the veins and they expand even more.

Without medical intervention, the process leads to the formation of blood clots and vascular inflammation.

As a result of the research, it was revealed that there is a genetic predisposition to this pathology, which is activated when provoking factors arise.

The main reasons for the development of varicose veins in pregnant women are as follows:

• increased load on the legs;
• hormonal imbalance;
• decreased physical activity;
• change in the consistency of blood;
• tendency to thrombosis;
• an increase in the size of the uterus.

Varicose veins, the treatment of which during pregnancy requires considerable effort, develops in mainly due to a significant increase in body weight, as a result of which the load on the legs increases women. By the end of pregnancy, on average, weight gain is about 10 kg, which is the provoking factor of the disease.

During pregnancy, hormones change. In particular, the production of progesterone increases. It is needed in order to relax the muscles of the uterus and facilitate the process of stretching. The influence is also exerted on the walls of blood vessels, which also relax and stretch.

The movement of blood up the vessels is partly provided by the contraction of the muscles of the lower extremities when walking. During pregnancy, especially in the later stages, women move less, spend more time lying or sitting.

The result is a decrease in the intensity of blood circulation, leading to stagnation in blood vessels and varicose veins. To avoid this, it is recommended to increase physical activity.

The blood of a pregnant woman becomes less viscous. In this state, it better supplies the fetus with all the necessary substances. This increases the venous pressure, which can negatively affect the condition of the vessel walls.

In a pregnant woman, the level of blood clotting increases. In this way, the body protects itself against large blood loss during childbirth. But the high ability to coagulate makes the blood prone to thrombosis, it can accumulate in clots that press on the walls of the veins, stretching them.

Classification and stages of the disease

There are several types of varicose veins that differ in localization.

During pregnancy, one of the following may develop:

• varicose veins of the lower extremities;
• vagina;
• uterus;
• in the groin area.

The expansion of the veins in the pelvic organs occurs as a result of anatomical changes during pregnancy and the compression of the vessels of the small pelvis.

There are 3 stages of varicose veins:

• stage of compensation;
• stage of subcompensation;
• stage of decompensation.

At the stage of compensation, the walls of the veins are already undergoing some changes, but the vascular system is still working normally. It is asymptomatic or with the manifestation of nonspecific symptoms - fatigue in the legs, swelling, frequent cramps. Before the transition of the disease to the stage of subcompensation, vascular networks appear on the skin, veins become painful on palpation.

At the stage of subcompensation, the symptoms intensify. Clearly visible cyanotic nodes of enlarged veins appear. Itching appears in the affected area. Painful sensations arise. Convulsions become more frequent. It is impossible to return the veins to their normal state in a non-invasive way.

If there is a risk of complications, surgical treatment is recommended for a patient with stage II varicose veins. Pregnant women with subcompensated varicose veins do not undergo surgery without an urgent need. Instead, medication is prescribed, which stops the development of the disease until the moment. The operation is performed after childbirth.

The stage of decompensation is characterized by disruption of the vascular system and the manifestation of complications of varicose veins.

Possible complications

But in a neglected state, varicose veins are fraught with quite serious consequences:

• During pregnancy, deep vein thrombosis of the lower extremities can develop quite quickly, which leads to impaired blood flow.
• There is a risk of blood clots forming in the vessels located in other parts of the body. At the site of localization of a thrombus, thrombophlebitis can develop - inflammation of the vessel.
• The last stage in the expansion of veins is their destruction, which leads to inflammation of the adjacent tissues - skin, bones, tendons. Inflammatory lesions of this nature are very difficult to stop. They are called trophic ulcers.
• In some cases, thrombosis of the umbilical cord vessels occurs. As a result, the fetus experiences nutritional deficiencies and hypoxia, and its growth slows down.
• A blood clot from a vein in the legs or pelvis can block the pulmonary artery or one of its branches. Pulmonary embolism is one of the most common causes of death in pregnant women.

Features of the course of the disease during pregnancy

Varicose veins usually develop rapidly during childbearing. Complications are dangerous not only during pregnancy, but also during childbirth. Therefore, this disease requires treatment as soon as the first signs appear.

According to doctors, in women with a predisposition to varicose veins, the risk of the manifestation of the disease increases with each subsequent pregnancy. If the first symptoms made themselves felt already during the bearing of the first child, then with the onset of the next pregnancy, it is imperative to inform the doctor about this.

Diagnostics (ultrasound, tomography)

A gynecologist or therapist can detect varicose veins. A phlebologist is involved in the treatment of blood vessels. On close examination, the disease is determined by skin signs at an early stage.

The diagnosis is straightforward. The task of the doctor at the diagnostic stage is to identify the stage of the disease and its localization.

For diagnostics, the following examination methods are most often used:

• examination on the chair;
• Vascular ultrasound;
• MRI.

When examined on a gynecological chair, varicose changes in the genitals are revealed. The stage of varicose veins is determined by the level of edema and tissue hypertrophy.

Having found signs of the disease, the doctor prescribes an ultrasound of the vessels, which is carried out using Doppler. The examination allows you to see the vessel from the inside and assess its condition. With the help of ultrasound of the vessels, varicose and atherosclerotic changes are easily detected, the localization and size of blood clots (if detected) are determined, and the blood flow rate is measured.

If a serious pathology was detected during an ultrasound examination of the vessels, the doctor may prescribe an MRI for an expert diagnosis.

Treatment of varicose veins in pregnant women

Not all known treatments can be used during pregnancy. Many drugs for oral administration and external use during this period are contraindicated for women. In cases of detection of the disease at the initial stage, non-drug treatment may be prescribed - changing the diet, performing gymnastics, wearing compression underwear, massage.

Varicose veins, the treatment of which during pregnancy can do with preventive measures that stop the development of the disease, requires careful supervision of a specialist. If a rapid deterioration is detected, treatment with pharmaceuticals is prescribed.

Correct daily routine

In order not to provoke the development of varicose veins, you need to move more, eat exceptionally healthy foods, and rest on time. It is advisable to draw up a daily regimen and take into account the time for meals, walks, exercise, daytime rest.

Gymnastics

With varicose veins at the initial stage, proper physical activity is important.

At home, you can perform a set of simple exercises:

1. Sitting on a fitball or a chair, you need to put your feet with your whole foot on the floor and, without lifting your heels, raise only your socks. It is necessary to perform the exercise 20-25 times in 1 approach.
2. In the same position, raise only your heels without lifting your toes. Do it 20-25 times in 1 approach.
3. Walk barefoot on the floor, first on your heels, then on your toes. Do it until you feel tired in your legs.
4. Rest your arms outstretched against the wall, in a standing position, roll 20 times from heels to toes and from toes to heels.
5. During the first and second trimester, during the normal course of pregnancy, breathing exercises can be done. In a standing position, a deep breath is taken, at the same time the arms are raised, while exhaling, the arms are lowered down.
6. Lying on your back with bent legs, perform rotations with one, then the second knee. First, 5 rotations are done in one direction, then 5 in the other.
7. If the state allows, the exercise "bicycle" is performed. A few movements forward and the same amount back are enough.
8. Lying on your back, put your feet on the wall, and "walk" up and down it.
9. At the end of gymnastics, you can just dance a little to your favorite, not very fast music.

Cold and hot shower

A contrast shower is useful in that it stimulates blood circulation, reducing the likelihood of blood stagnation in the vessels. The procedure should start with warm water. When the body warms up, make the water cool, after a couple of minutes return it warm again, and so on several times. The water procedure should not be carried out at extreme temperature changes and cause a state of severe discomfort.

Compression jersey

With the help of compression garments, you can improve the condition of the veins in the legs and stop their further deformation. Such linen squeezes superficial and deep veins, narrowing them. Thus, the speed of blood flow is increased. As a result, stagnation is eliminated.

Compression underwear is available in different versions - leggings, tights, stockings, knee-highs. Has a different degree of compression. The product should be chosen according to the doctor's prescription.

The right shoes

To reduce the load on the legs and block the development of varicose veins, you need to wear comfortable orthopedic shoes. It should be made from natural materials, with a high-quality last, matched exactly to the size. Other important criteria are stability, even distribution of pressure on the foot, reliable fixation, and the absence of crushing elements.

Rationalization of nutrition, drinking regimen

When composing a correct diet, the first step is to exclude all products that retain water in the body - pickles, smoked meats, sweets, baked goods, fast food. In addition, you need to exclude fatty and fried foods. Better to cook steamed or in the oven.

To normalize blood flow, it is recommended to eat fractionally - 5 or 6 times a day. There are more fruits, vegetables, herbs, berries - foods that prevent blood viscosity. It is very important to ensure the normal functioning of the liver by removing food with preservatives, dyes, flavor enhancers, as well as spicy and salty foods from the diet.

To avoid blood stagnation and the formation of clots in it, a pregnant woman needs to drink at least 2.5 liters of fluid per day. You need to drink throughout the day in small portions.

Drug treatment

Varicose veins, the treatment of which during pregnancy cannot be limited by preventive measures, requires the use of drugs. They do not cure the disease, but relieve symptoms and slow down the process of further expansion of the veins. The vessels can be completely cured after childbirth and breastfeeding.

Treatment of varicose veins during pregnancy is carried out using external agents permitted for use during this period.

Most often they are prescribed:

• Venoruton;
• Heparin ointment;
• Hepatrombin;
• Troxerutin;
• Lyoton.

If necessary, to enhance the effect with drugs for internal use, doctors prescribe one of the following:

• Venoruton;
• Ginkor Fort;
• Troxevasin;
• Detralex;
• Phlebodia.

Folk remedies

At the initial stage of the disease, when varicose veins are manifested only by small asterisks on the skin, you can use proven folk remedies. But first, it is recommended to consult with your doctor.

The most common folk recipes for the treatment of varicose veins:

Wormwood compress	Wormwood flowers are ground until smooth. After that, add a little milk and apply the mixture to the legs. A bandage is applied on top. Remove the compress after 2 hours.
Potato compress	Grate a few potatoes on a coarse grater, put on a cloth and bandage to a sore spot. Take off after 4 hours.
Kalanchoe rub	Make an alcoholic tincture from the plant and rub it on your feet daily for 3 months.
Green tomato compress	The vegetable is cut in half and applied to the affected area. Keep until a burning sensation appears.
Horse chestnut tincture	Pregnant women use it as a wipe. But if the doctor permits, you can take it orally, in a diluted form, in a few drops.
Apple vinegar	This tool is also used both as a wipe and as a medicine for internal use. In the second case, special care must be taken. It is advisable to consult a doctor before starting the course of treatment.

Operative treatment

Surgery is rarely used during pregnancy. Only in three cases, when complications of varicose veins become a threat to the woman herself or the fetus. For example, when a trophic ulcer or thrombophlebitis is detected. Surgical treatment is carried out no later than 6 months of pregnancy. In special cases, veins are hardened by introducing special solutions into them.

What not to do when pregnant

Throughout the entire period, you should refrain from skin-traumatic cosmetic procedures, such as waxing or peeling. They can provoke a malfunction of blood vessels and their deformation. In addition, it is not recommended to stay under the sun for a long time, take a hot bath and visit the sauna.

Pregnant women with varicose veins in everyday life should not:

• sit for a long time in an uncomfortable position;
• wear tight-fitting clothing;
• wear tight shoes and shoes with heels;
• overload your legs.

When urgent medical attention is required

During pregnancy, varicose veins can progress rapidly. At the same time, vascular changes are fraught with fetal health. Therefore, the first symptoms, which do not even bring physical discomfort, are a reason for an urgent visit to a doctor. The sooner the doctor prescribes treatment for varicose veins, the less chance of complications during childbirth.

How is childbirth with varicose veins

Varicose veins, the treatment of which during pregnancy is carried out as sparingly as possible, can pass into a more severe stage by the time of childbirth. However, this is not a contraindication to natural delivery.

To prevent vascular deformation from leading to complications in childbirth, hemostasis is diagnosed from the 38th week of pregnancy. If necessary, anticoagular therapy is prescribed - the administration of drugs that slow down blood clotting and prevent the formation of blood clots.

If the disease has already reached the stage of blood clots, pain relievers and heparin are administered to the woman throughout the entire process of childbirth. In severe cases, the woman in labor is pre-installed with a KVA filter, which prevents the blood clot from moving into the pulmonary artery.

In case of complications with a threat to the life of the mother or child, prompt delivery is performed.

The course of the disease after childbirth

In most cases, stage 1 varicose veins, which appeared during pregnancy, disappear after childbirth. The hormonal background is normalized, the elasticity of the vascular walls is restored, and the symptoms of the disease disappear. This process usually takes up to 4 months. But sometimes the vessels take longer.

If the veins are significantly deformed, it is recommended to wear compression underwear for the first month and a half after childbirth. According to the doctor's prescription, during this period, they take venotonic drugs, do a special massage. If surgical treatment is necessary, the condition of the veins is maintained by non-invasive methods while the woman is breastfeeding. After that, the operation is performed.

Arising or worsening varicose veins causes rapid fatigue and heaviness in the legs during pregnancy. It is important to remember that it can develop rapidly and reach the stage of thrombosis and thrombophlebitis.

Only the right treatment can significantly reduce the level of discomfort caused by the violation functions of the venous system, as well as to prevent possible negative consequences for the body women. After childbirth, it is necessary to continue treatment, if necessary, with the use of methods and drugs that are contraindicated during pregnancy.

Author: Maksimova Oksana Evgenievna

Video about varicose veins

How to treat varicose veins during pregnancy: