Pregnancy
About half of all women develop varicose veins in their first pregnancy. Even more women are affected in their second.
And the risk of venous occlusion increases as well: pregnant women have a three to five times higher risk of thrombosis compared with non-pregnant women. This risk rises even further for up to six weeks after the baby's birth – especially after a caesarean section or major blood losses.
The increased susceptibility to venous disorders is caused by the hormonal changes and increase in the amount of blood, which rises by about 20 per cent even at the start of pregnancy. The weight gain also increases pressure on the leg veins. The growing uterus and the baby's head also put pressure on the veins in the pelvic region and impede the flow of blood back to the heart. The greater "the bump" becomes, the more lumbering and less mobile one becomes, so the calf muscle pump is also less activated.
Even women who have previously shown no signs whatsoever of venous weakness can suffer consequences as a result of this increased load. Legs swell up and so-called varicose veins of pregnancy develop that often, but not always, disappear after the child is born. It is in women who carry additional risk factors – for example an inherited weakness of connective tissue or excess weight – in whom a pregnancy often marks the start of a constant venous disease.
Prevent with compression
The wearing of compression stockings can prevent venous disorders in pregnancy. Compression Class I is sufficient here. In the case of existing venous problems or marked accumulation of fluid, compression Class II can also be used. The stockings should be worn from the third month of pregnancy until two months after delivery or until the end of breast-feeding.
If necessary, additional preventative measures against a thrombosis will be taken in the hospital or maternity ward. These consist of special compression stockings – anti-embolism stockings, exercise and possibly also treatment with anticoagulant drugs. In the case of home births or ambulatory deliveries, you should discuss possible precautions with your doctor in good time.
Swollen legs during pregnancy can also be signs of the HELLP syndrome or pre-eclampsia. Please always discuss this with the doctor treating you.