By Dr. Himanshu Verma, Senior Consultant Vascular and Endovascular Surgery at FMRI Gurugram

Varicose veins affect a significant number of pregnant women, with up to 40% experiencing this condition. During pregnancy, hormonal changes and increased blood volume cause the veins to relax and dilate, leading to prominent veins in the pelvis and legs. The expanding uterus also exerts pressure on the inferior vena cava, resulting in leg vein congestion, swelling, and the appearance of varicose veins. Excessive weight gain during pregnancy can further contribute to their development. It is common for varicose veins to become more visible post-delivery as the swelling subsides.

Unfortunately, many women only seek medical help when varicose veins become painful or complications arise, such as swelling or ulcers. Traditional clothing practices that cover the legs may hide visible veins, delaying diagnosis and treatment. Therefore, it is crucial to be aware of the signs and take preventive measures.

If you notice prominent veins or swelling in your legs during pregnancy, remember the "3 W's" for relief: adequate Water intake, Wearing compression stockings regularly, and regular Walking. Maintaining proper hydration is vital, and urine color can serve as a helpful indicator. Dark-colored urine suggests insufficient water intake, which can increase the risk of clot formation in the veins. Therefore, aim for clear urine by drinking enough water throughout the day.

Compression stockings, expertly sized to your legs and ankles, promote blood flow from the legs to the upper body. Start by wearing them for 6-8 hours daily and gradually increase to 10-12 hours. It is recommended not to remove the stockings during the day and even sleep with them on. If you experience dryness or itching, applying moisturizer before and after wearing the stockings can provide relief. In case of allergy, cotton-based stockings can be considered.

Regular walking, especially while wearing compression stockings, helps maintain blood flow against gravity, controls leg swelling, and reduces the likelihood of developing varicose veins. In rare cases where varicose veins cause severe symptoms, certain treatments like endovenous laser treatment or Venaseal Glue ablation can be performed during pregnancy, preferably in the early stages.

To prevent clot formation during and after pregnancy, it is crucial to address stasis, which refers to stagnant blood flow. Pregnancy itself increases the risk of clot formation due to hormonal and physiological changes. Maintaining an active lifestyle, including regular walks and the use of compression stockings if experiencing leg swelling or pain, is essential in preventing clot formation.

Women with a history of clot formation should consult a vascular specialist before planning a pregnancy. Depending on the risk of recurrent clotting, preventive measures such as prophylactic blood thinners may be recommended.

In conclusion, varicose veins can occur during pregnancy due to hormonal changes, increased blood volume, and pressure on the veins from the expanding uterus. Timely recognition and preventive measures, such as adequate water intake, regular use of compression stockings, and maintaining an active lifestyle, can alleviate symptoms and reduce the risk of complications. Consultation with a vascular surgeon is advisable to manage varicose veins effectively during pregnancy.

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