Varicose veins between the legs during pregnancy. Varicose veins in pregnant women. What to do with varicose veins in the groin during pregnancy

Varicose veins are susceptible to veins located in layers that are easily compressed and do not provide sufficient resistance to increased pressure - in the subcutaneous fat or submucosal layer of internal organs.

Varicose veins of the genital organs (labia, vulva, vagina, uterus) are quite common - up to 30% of pregnant women suffer from it.

The etiology of the disease during pregnancy

The main reasons for the appearance of varicose veins of the pelvic organs, in particular the uterus, vagina, vulva and labia, in pregnant women include:

Risk factors that provoke the occurrence of varicose veins of the labia, vulva, vagina and / or uterus include:

Pregnancy provokes the appearance of varicose veins, as it creates conditions for increased pressure in the pelvis. The pregnant uterus squeezes the veins of the small pelvis, making it difficult for blood to move through them, and the physiological increase in blood viscosity aggravates this condition.

Manifestations and complications of varicose veins during pregnancy

Clinical manifestations of genital varicose veins during pregnancy depend on the location and extent of the pathology, the stage of the disease and the duration of pregnancy. There are varicose veins of the internal (vagina, uterus and appendages) and external genital organs (vulva, labia).

Symptoms of varicose veins of the external genital organs are:

The symptoms of vaginal varicose veins are somewhat different from the symptoms of external varicose veins:

• feeling of fullness and burning in the vagina;
• soreness during intimacy;
• pulling pains in the vagina that radiate to the groin, occur or intensify after physical exertion;
• sometimes - bloody discharge from the vagina or impaired urination;
• when viewed in the mirrors, varicose veins under the vaginal mucosa are determined.

Varicose veins of the uterine veins are often asymptomatic or with minimal symptoms (for example, aching pain in the lower abdomen).

Varicose veins of the uterus in pregnant women manifest themselves in the form of non-specific symptoms:

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When viewed in the mirrors, pathology is often not detected. When the cervix is ​​involved in the process, the doctor may see cyanosis and swelling of the cervical mucosa, sometimes dilated vessels appear through the mucosa.

To make a diagnosis of uterine varicose veins, a survey and examination is not enough. A more informative picture is given by additional research methods:

During pregnancy, the diagnosis of varicose veins of the uterus is difficult, since many additional research methods during pregnancy are dangerous and are temporarily prohibited from being used (extrauterine phlebography, laparoscopy, computed tomography).

Varicose veins of the internal genital organs during pregnancy are dangerous for their complications:

Approaches in the treatment of illness in pregnant women

Often, varicose veins of the pelvic organs of a pregnant woman go away on their own after childbirth, since the main risk factor, the pregnant uterus, disappears.

Treatment of varicose veins of the pelvic organs during pregnancy is difficult, as it is dangerous for the fetus and is fraught with complications during pregnancy.

Therefore, the treatment of varicose veins of the pelvic organs during pregnancy is limited to conservative non-drug methods. The main methods of treating varicose veins during pregnancy include:

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The presence of varicose veins of the small pelvis in a pregnant woman requires a woman to lead a special lifestyle, to avoid risk factors that can cause its progression. The best option for a normal pregnancy in women with pelvic varicose veins is to plan for pregnancy and treat the disease before it occurs.

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As medical statistics show, every 5th woman is accompanied by varicose veins in the groin during pregnancy. The groin is considered the lower part of the abdominal region adjacent to the thigh. Peripheral veins are concentrated here, providing blood flow to the genitals, both in men and women.

Causes of the disease and risk factors

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As the fetus grows, a woman often experiences unpleasant, painful sensations. in the lower abdomen. The cause of these sensations can be varicose veins in the groin and in particular, the labia, vagina. This causes pain that radiates to the sacrum, lower abdomen.

Varicose veins of the perineum during childbearing can develop for the following reasons:

• Physiological increase in the amount of blood in a woman's body. Blood provides nourishment not only to the organs of a woman, but also to a growing new organism.
• Hormonal changes, the ratio of estrogen and progesterone:
• the growing fetus compresses the blood vessels, which leads to impaired blood circulation in the groin area.
• Excess weight, resulting from a weakening of control over nutrition, increased progesterone in the body and the weight of a growing fetus. Some pregnant women are addicted to sweets, while others have an incessant need for food.
• Inflammatory processes in the external genital organs of a woman, for example, vulvitis, bartholinitis, vaginitis.

More often than others, inguinal varicose veins are affected by women who have

• Genetically weak venous walls, or valves are not developed;
• sedentary, sedentary lifestyle;
• On the contrary, working conditions require long standing;
• There is a tendency to alcoholism. Regular poisoning of the liver or its diseases can also cause varicose veins and thrombosis.

Classification

Inguinal varicose veins is a generalized concept and they are classified depending on the location of the venous nodes:

• Varicose veins of the perineum (the area between the anus and the vagina).
• Varicose veins of large or small labia;
• Varicose veins of the vagina.

Venous transformation, the formation of swelling and nodules, in addition to localization, differs in the severity of the pathology, on which the symptoms and signs of the disease depend.

Venous nodes, thickenings in the perineum and labia majora can be felt by a woman on her own. There is dryness and bluish color of the skin. But venous thickenings are especially pronounced on the mucous membranes of the vagina and labia minora.. The mucosa itself acquires some friability.

In the moderate and severe form of varicose veins, a woman feels a pulling pain in the groin, or in the perineum, which is aggravated by long walking, lifting weights. In a mild degree, burning sensation, discomfort are felt.

With varicose veins of the vagina, a woman experiences bursting, intimacy is accompanied by pain. In places of thrombus formation, the skin and mucous membranes acquire a bluish tint, nodules are felt in the affected areas.

Women whose vessels are prone to swelling and knotting also acquire, as evidenced by the appearance of stars and protruding blue streaks on their legs.

Danger and complications of inguinal varicose veins

Varicose veins have three degrees of severity. The most dangerous is the third degree. It is she who can cause thrombophlebitis, hemorrhoids, acute placental insufficiency. At this stage, there are practically no venous valves on the swollen parts of the veins, the walls are very thinned, and the blood forms blood clots.

In this pathogenic degree, it poses the greatest danger, since thinned venous walls can burst at any moment, with the slightest sudden movement, and this will cause profuse bleeding, which poses a threat to the life of the mother and her unborn child.

Women's fears

For any woman, the birth of a child is a serious stress both on the physical and psychological levels. Women are afraid of childbirth. And women who have problems with blood vessels in the area of ​​​​the birth canal experience a double fear. knowing about possible ruptured veins.

Usually, women suffering from varicose veins in the groin area are under close supervision of a phlebologist and a gynecologist at the same time. And shortly before the birth, she undergoes a serious examination to see if she can give birth on her own.

If nothing threatens the health of the future mother and her baby, the doctor will suggest that she give birth naturally. If the health of the veins is critically endangered, she will be offered a caesarean section. Surgical obstetrics is also prescribed if venous thickenings close the birth canal. Caesarean section for severe varicose veins is the best option.

After the birth of the baby, the veins usually return to normal, but since each subsequent pregnancy complicates the course of varicose veins, after the birth of a child, it is recommended to undergo a thorough examination and the appropriate course of treatment.

Treatment Methods

The earlier treatment is started, the more likely it is that varicose veins will not interfere with the natural birth of the baby. In the fight against inguinal varicose veins, in no case should you self-medicate. Even if these are herbs used in traditional medicine.

The fact is that among the seemingly harmless herbs, there are many that seriously affect the muscle tone of the uterus and can provoke a miscarriage.

And everyone's favorite nettle, often used by women as a hemostatic agent, contributes to thickening of the blood and the formation of blood clots. And there are many such examples, when the use without knowledge of the properties of certain therapeutic agents and methods leads to the opposite or side undesirable effect.

Methods - drug and non-drug are developed by a phlebologist together with a gynecologist, who will warn that it is contraindicated for the normal course of pregnancy.

First of all, pregnant women are recommended to wear special compression underwear. These are knitted squeezing tights for pregnant women from varicose veins, stockings, belts and panties, which, having a squeezing, massaging effect, in fact stimulate blood flow, take on the work of some muscle groups.

Thanks to the action of such underwear, blood stagnates less in the vessels, swelling and fatigue are removed, the load is distributed more evenly, blood flow improves. But the size and type of underwear is also selected by the phlebologist.

With all the positive factors, he also has contraindications. It can not be used for any diseases and skin lesions.

Medicines, medicines

Of the medicines against varicose veins, creams, ointments, and tablets are used. For a pregnant woman, a doctor may recommend ointments based on horse chestnut and heparin - Lyoton-gel, Venitan, Troxerutin. With varicose veins of the vagina, treatment is carried out with tampons. The perineum and labia are lubricated with the drug.

Preventive measures

When working on your feet, on the contrary, you should not miss the opportunity to sit. It is easier for a non-working woman to plan her schedule. It must include outdoor walks, swimming, or at least a contrast shower, daytime rest, lying down, with legs raised.

Swimming not only relieves stress and heaviness from organs suffering from varicose veins, but also strengthens the spine, which is important for a future mother.

A pregnant woman should be attentive to her diet. It should contain as many vegetables and fruits as possible, flour and sweet, on the contrary, less. Nutrition for varicose veins should be balanced, include antioxidants - vitamins C and E, trace elements iodine, selenium. All this is available in sufficient quantities in citrus fruits, currants, mountain ash, walnuts.

In contact with

During the bearing of a child, the female body is subject to changes. Inguinal varicose veins during pregnancy occurs due to excessive pressure of the growing uterus on the internal organs. The disease itself is often observed in the area of ​​the lower extremities, it is visually definable and causes a lot of inconvenience. Pregnant women are exposed to varicose veins in the groin area for many reasons, including hormonal imbalances, especially during pregnancy. This pathology requires special attention and qualified treatment.

Etiology

Varicose veins in women who are in a “position” are a common and logical phenomenon. It occurs due to cardinal changes in the body and due to stable loads on the groin area due to the growth of the baby. In addition, at this time, the hormonal background changes and disturbances in the system are not excluded. The main factor during pregnancy, which becomes the main cause of this phenomenon, is a sharp increase in the level of the hormones progesterone and estrogen, which have a relaxing effect on the veins and blood vessels. Over time, they weaken, lose elasticity, become weaker and easily stretchable. Varicose veins also occur for reasons such as:

• fetal growth;
• impaired blood flow in the pelvic organs;
• increased blood volume;
• chronic diseases of the genital organs;
• low mobility;
• physiological disorders of venous valves;
• obesity;
• constipation;
• congenital pathology of the structure of the veins;
• genetic predisposition;
• the presence of varicose veins on other parts of the body;
• hormonal changes in the body;
• increased thrombus formation.

Symptoms

One of the brightest manifestations of pathology is drowsiness.

Before the blue and swollen veins in the inguinal region begin to appear, the woman begins to feel a burning sensation and itching. The labia looks swollen and this condition is always accompanied by aching pains in the groin. Discomfort worsens in the evening, especially if the patient has spent most of the time in a sitting position or has been subjected to heavy loads. Over time, small nodules begin to appear, soft to the touch and easily identifiable visually. At this time, a woman constantly experiences inconvenience, it is difficult for her to move around, there is a complete rejection of intimacy. There is general fatigue and drowsiness, radiating pains in the lower extremities begin, possibly numbness. In addition, in many women, a trophic change in the skin of the lips is fixed, dryness, slight pigmentation, vascular "asterisks" and irritation appear.

At the first symptoms of varicose veins, you should consult a doctor. You should not hope that the phenomenon will pass on its own after childbirth, because during gestation, the problem can worsen and lead to serious consequences.

Diagnostics

You can determine varicose veins of the perineum during pregnancy on your own at home, subject to careful examination and monitoring of the general condition of the body. But only a specialist can diagnose the disease based on the results of a series of events and studies. Varicose veins in the groin in pregnant women are determined by a phlebologist - a narrow specialist who prescribes the necessary examinations and tests. After anamnesis and examination, the doctor prescribes several procedures that will help determine the degree of damage and the condition of the veins and blood vessels. In practice, the following methods are often used:

• duplex scanning;
• Ultrasound of the veins of the pelvic organs;
• general blood analysis;
• expanded coalogram.

Treatment of varicose veins

Often, varicose veins in the perineal area go away on their own after delivery, but targeted therapies can eliminate unpleasant symptoms and discomfort during pregnancy. Since this condition requires a special organization of therapy without an aggressive effect on the body of the mother and child, drug treatment and wearing compression underwear are often prescribed. In certain cases, moderate physical activity and exercises are recommended that will not cause complications and will positively affect the condition of the woman.

Childbirth with varicose veins

The disease is not a contraindication to bearing a fetus. The presence of pathology requires special attention during childbirth. After consultation with a gynecologist and phlebologist, a decision is made on the method of delivery: naturally or by caesarean section. The priority is independent childbirth, in which the patient is put on compression stockings or wraps her legs with an elastic bandage to prevent backflow of blood during attempts. Caesarean section is performed if there is a risk of rupture of the veins from physical exertion during natural childbirth, as well as in case of problems with the patency of the birth canal. Childbirth with varicose veins often takes place without complications, if all therapies have been previously carried out.

Varicose veins during pregnancy in the groin is a phenomenon that occurs in 30% of women, and with each subsequent pregnancy, the risk of developing pathology increases. The first signs of the disease appear at the beginning of the 3rd trimester of pregnancy, but sometimes this happens as early as the 2nd trimester.

Often, varicose veins of the inguinal region is a complication of lower extremity disease, and sometimes - its harbinger. The pathological process can affect the saphenous veins of the external organs, uterus and vagina, iliac veins.

Varicose veins during pregnancy in the groin is a phenomenon that occurs in 30% of women, and with each subsequent pregnancy, the risk of developing pathology increases.

Causes

During pregnancy, hormonal changes occur in a woman's body.

The main reason for the development of varicose veins in the perineum is progesterone, which is produced in large quantities during the period of bearing a child, increases blood pressure, increases the volume of circulating blood and at the same time reduces the muscle tone of the veins, contributes to their expansion.

At the same time, during pregnancy, the pressure of the enlarging uterus on the pelvic vessels increases: the inferior vena cava and iliac veins. The outflow of blood from the lower extremities, external genital and pelvic organs worsens, the lumen of the veins increases, the venous wall becomes thinner, nodes appear - local expansions of the vessels.

It exacerbates congestion and weight gain during pregnancy. Due to the increased load on the lower limbs, superficial vessels that do not have muscle support are the first to suffer.

The development of varicose veins in the groin area during pregnancy largely depends on the genetic predisposition. Heredity determines such characteristics of the vascular wall as density, elasticity, viability of venous valves, and the presence of structural anomalies.

Lack of muscle activity, chronic inflammatory processes in the organs and tissues of the genitourinary system, long-term use of hormonal contraceptives before pregnancy and hormone-containing drugs during it, diseases of the cardiovascular system, frequent constipation, high intra-abdominal pressure, increased viscosity and blood clotting, chronic diseases of the endocrine system aggravate the course of the disease.

Vaginal varicose veins often develop on the background of sexual dysfunction or as a result of a change in the position of the uterus, and inguinal varicose veins - as a result of weight lifting, prolonged static body position (standing, sitting, lying) and too intense physical activity.

Women with a history of difficult births are more likely to develop varicose veins in the groin during a subsequent pregnancy. In addition, the disease can develop at an earlier time - already in the 2nd trimester.

Symptoms

Inguinal varicose veins during pregnancy has the following symptoms:

Varicose veins of the vagina and uterus during pregnancy are often asymptomatic. With a strong stretching of the veins, aching pain appears in the lower abdomen, which spreads to the entire groin, lower back, buttocks. Because of the pain, sexual intercourse becomes impossible, copious discharge from the vulva is possible.

Treatment

If the veins on the genitals of a pregnant woman are swollen, you should immediately contact a phlebologist. To confirm the diagnosis, you will need to conduct a detailed blood test that allows you to assess the number of platelets, a comprehensive analysis of coagulation indicators (prothrombin index, thromboplastin time, fibrinogen A and B, international normalized ratio), ultrasound of the pelvic vessels and lower extremities. Based on the examination, treatment is prescribed.

In most cases, conservative treatment is effective during pregnancy. In addition, most women experience spontaneous healing after delivery.

A woman during pregnancy must wear pantyhose or pantyhose, which contribute to the outflow of blood and increase blood circulation.

If the disease continues to progress after the birth of a child, sclerotherapy, phlebectomy, laser or electrocoagulation of the affected vessels are performed.

Medicines

For the treatment of varicose veins in the groin during pregnancy, drugs are used that have a tonic effect on the walls of blood vessels, reduce pain and swelling, prevent the appearance of blood clots, and improve blood microcirculation.

Pregnant women are prescribed gels or ointments for external use, acceptable for use from the 1st trimester of pregnancy: Venoruton, Troxevasin, products containing heparin (Lioton 1000, Heparin gel), preparations with horse chestnut extract (Venitan, Escuven) or gingko biloba (Ginkor and other).

Ointments are applied with light movements, without rubbing or squeezing the veins, 2-3 times a day.

Inside, drugs containing diosmin and hesperidin (Detralex, Venarus), horse chestnut extract (Aescusan) are used, oral angioprotectors are practiced from the 2nd trimester of pregnancy.

Additionally, patients during pregnancy are prescribed antioxidants and vitamins (C, PP, group B, fat-soluble vitamins), as well as calcium, zinc, selenium.

Gymnastics

Pregnant women with varicose veins will benefit from swimming, water aerobics, yoga, outdoor walks and special gymnastic exercises.

A simple but effective set of exercises:

Exercise during pregnancy is best done using a bandage.

Danger and complications

Against the background of varicose groin disease, varicose veins of the internal organs of the small pelvis, thrombophlebitis, thrombosis, trophic ulcers may develop, bleeding may open. The risk of complications is especially high during childbirth.

Prevention

In order for the veins in the groin not to expand and swell, from the first days of pregnancy it is important to adhere to a healthy lifestyle: eat right, do therapeutic exercises, spend enough time in the fresh air, avoid static positions, give up bad habits and alcohol. It is especially important to adhere to these rules for women at risk who have a genetic predisposition to the development of the disease, varicose veins or a history of difficult childbirth.

Moderate loads during pregnancy should be alternated with proper rest, during which it is better to raise the legs a little.

You will have to give up uncomfortable and unstable shoes. It is better to choose underwear during pregnancy without seams, with supportive inserts, made from natural fabrics.

Light self-massage without pressure and rubbing will be useful. During pregnancy, you will have to refuse to visit the sauna, hot showers and baths. You can take a contrast shower with a small temperature difference. This procedure tones the blood vessels.

It is better to sleep on the left side, placing a small pillow under the stomach. This will help avoid squeezing the inferior vena cava.

Diet

Nutrition during pregnancy in the presence of vessels damaged by varicose veins should help reduce blood clotting and viscosity, improve vascular tone and strengthen their walls. It is also important to control weight gain. For 1 week, the expectant mother should not gain more than 300 g, so as not to increase the load on the vascular system.

During pregnancy, you need to eat fractionally, choosing foods rich in vegetable fibers, vitamins, proteins, omega 3 and 6, macro- and microelements.

The diet should include:

The diet should be tailored to individual food tolerance and gestational age. The drinking regime is also important. On the day, a woman should drink a sufficient amount of liquid (water, fruit drinks, compotes, teas), taking into account liquid food.

Compression underwear

For the treatment and prevention of varicose veins in the groin and lower extremities, wearing compression underwear is practiced, which compresses the stretched veins, returning them to their original volume and ensuring the outflow of venous blood to the heart, compensating for the insufficiency of intravascular valves. You can bandage your legs with elastic bandages.

Compression underwear is worn every day until childbirth. It must be worn in the morning and washed daily. The selection of such underwear during pregnancy and the determination of the degree of compression should be carried out by a phlebologist. During childbirth, such underwear is necessary to reduce pressure in the veins of the small pelvis, protect blood vessels from excessive stretching during contractions and attempts.

During pregnancy, a woman is especially vulnerable. Most often, due to hormonal changes in the body associated with the bearing of the fetus, all chronic diseases that bothered the young mother before appear.

One of the serious problems during this period is the expansion of the veins in the groin. It is worth noting that this disease is not an obstacle to natural childbirth, but can lead to serious consequences.

Causes

A variety of reasons can lead to varicose veins in the groin area during pregnancy. The most common of them are the following:

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Symptoms

Varicose veins in the groin during pregnancy are very similar in their external manifestations to the same condition that occurs in the legs. First of all, with this disease, the following symptoms occur:

• discoloration of the skin in the groin and labia;
• the appearance of vascular networks and asterisks on the surface of the skin in the groin area;
• reshaping and enlargement of the external labia;
• increased dryness of the skin in the female genital area;
• discomfort in this area, including itching, burning, discomfort, soreness.

What to do with varicose veins in the groin during pregnancy

If you experience one or more of these signs, be sure to seek help from a specialist.

An additional examination using such means as a visual examination, a complete blood count, ultrasound of the venous system in the abdomen and hips will help diagnose the disease and prescribe the correct treatment for varicose veins in the groin during pregnancy.

In addition to consulting an obstetrician-gynecologist, a woman may need to consult a vascular surgeon. Don't ignore his advice. Properly prescribed and carried out treatment can minimize the risk of negative consequences of varicose veins of the vulva and groin.

Usually enough conservative therapy is prescribed. A woman will definitely have to reconsider her lifestyle and eating habits.

After all, with varicose veins, in order to normalize blood circulation, you should move as much as possible, do not stay in the same position for a long time, it is advisable to swim and do special water aerobics for pregnant women. Popular today, gymnastics courses for expectant mothers, dance and yoga can also help.

At the first signs of varicose veins during pregnancy and for its prevention, you should immediately abandon junk food, as well as salty, spicy, spicy, fatty, smoked foods.

Be sure to wear special underwear made of compression fabric. a small degree of compression can alleviate the condition of the veins during pregnancy, reduce fatigue and improve the general well-being of a woman.

Special compression tights are especially effective for varicose veins in the groin. They distribute the load over the entire surface of the leg, thereby facilitating blood flow in the veins and vessels.

Medicines

In some cases, you can not do without taking special medications. Usually these are topical drugs that do not have a teratogenic effect on the fetus.

Most often, with varicose veins of the vulva and groin during pregnancy, drugs such as:

• Aescusan,
• Detralex,
• Glivenol,
• Venoruton,
• Troxevasin.

These and not only means can alleviate the condition of a woman's veins, relieve swelling and discomfort. But treatment on your own without consulting a specialist can lead to problems. For example, when breastfeeding, Detralex is contraindicated, and Glivenol is used with great caution in the first trimester.

In addition to medications, vitamin complexes containing vitamins of group B, C, PP and calcium are most often prescribed.

How to give birth

Due to varicose veins in the vulva and groin area, natural childbirth is not prohibited. But you need to seriously prepare for them.

Be sure to take preventive measures throughout pregnancy to increase varicose veins and the occurrence of its negative consequences. Specialists such as a vascular surgeon, a gynecologist and a phlebologist can help with this.

Only in especially serious cases do you have to resort to a caesarean section. But this is more the exception than the rule. Most often, with proper preparation, a woman gives birth herself naturally.

Effects

Usually, when varicose veins of the vulva and groin area occur, childbirth is of particular concern to a pregnant woman.

Although this is a serious disease, in most cases the birth of a child with it passes without any problems and complications, like in a healthy woman.

Only when there is too much difficulty in venous blood flow, doctors resort to caesarean section to reduce the risk of complications during labor and after it.

Also, due to varicose veins of the vulva and groin area, a pregnant woman may develop complications such as:

• rupture of the venous wall and bleeding;
• development of placental insufficiency, which can lead to fetal hypoxia and delayed development;
• thrombophlebitis;
• postpartum hemorrhage.

Prevention

In order to avoid complications that have arisen against the background of varicose veins in the groin, it is necessary to take measures from the first days of pregnancy to prevent this condition. Here are some recommendations from experts in this regard:

Following all these recommendations will help reduce the risk of developing varicose veins of the groin and vulva during pregnancy, even if you have a genetic predisposition to it. Moreover, the timely detection of symptoms and the start of treatment can protect a woman from complications, as well as possible problems during labor.