Don't Let Pregnancy Ruin Your Legs

A common misconception among patients and physicians is that young women with varicose veins should wait until they are finished with all pregnancies before addressing the venous disease. This advice unfortunately misses the fact that the natural history of venous insufficiency is for progressive worsening, especially during times when pregnancy hormones are elevated.

Specifically, estrogen and progesterone are muscle relaxers, and thus cause expansion of the vein wall, vein valve dysfunction, and elevated venous pressure that lead to varicosities and swelling. Some of these symptoms ease once the childbirth occurs, but the underlying venous reflux (backflow) often remains, only to recur in more dramatic fashion with successive pregnancies.

The photo here is of a 32 year old woman currently in the 8th month of her second pregnancy. She told me that the veins were an issue during her first pregnancy, but she was advised to defer treatment. Currently she is in significant pain, has taken leave from her job, and has another month of progressive symptoms and clotting risk before treatment can occur. Graded medical support hose help to a degree but do not resolve the underlying venous problems.

Her underlying problem is saphenous vein reflux (the most common cause of varicose veins), for which a endovenous ablation and phlebectomy, both office procedures, will be curative. The ablation is done using a small IV and a heated catheter that seals the vein shut, eliminating the source of backflow. The normal veins then naturally adapt and bring blood up the leg in normal fashion. These are typically procedures that medical insurance companies find to be necessary and within the medical plans (not cosmetic).

Through extensive experience and shared knowledge in the field of venous vascular disease, we have learned that it is optimal to intervene on the venous reflux between pregnancies. Waiting until women are finished with all planned pregnancies commits many to a progressively worsening condition with need for more extensive procedures.

Early and appropriate intervention in varicose vein disease, especially in this population of patients, will optimize results and minimize risk for complications related to venous disease. Be sure you seek the advice of a well trained and experienced expert in vascular care to ensure your best results.