Varicose veins are common during pregnancy because of normal physiologic effects, effects which cannot be controlled. Heredity also plays a role; there is a familial tendency toward the occurrence of bad veins which may be transmitted by either parent.
Varicosities are unlikely to appear in a first pregnancy, but when they occur, each succeeding baby makes them worse. Fortunately the enlarged veins regress between pregnancies— with the first few pregnancies after their initial appearance, almost completely, but only partially after the later pregnancies. The vessels first involved are most frequently on the inner aspect of the calf, but the process may begin in the space behind the knee or on the thigh, and may involve one leg or both. In the early stages the veins may appear as a spidery network of superficial blood vessels, but when more advanced they stand out as straight, tortuous or knotted, soft blue cords just beneath the skin.
Varicose veins may cause considerable discomfort, usually a dull ache after being on one’s feet for some time. Symptoms seem to bear no consistent relationship to the size or the extent of the varicosities.
To reduce the likelihood of developing varicose veins, do not wear round garters or attempt to hold your stockings up by twisting and knotting them about the knee.
If varicose veins develop during pregnancy, several measures may help: 1. Do not stand if you can sit and, when you sit, sit with your leg elevated so that your heel is above the level of the hips. Do not sit if you can fie and, when you lie, lie with your leg raised on a pillow. 2. Use elastic stockings or an ace bandage; either relieves discomfort and probably minimizes the tendency of the varicosities to worsen. Both must be applied before arising, while ‘ you are still in bed and the veins are empty. Elastic stockings may be purchased singly or in pairs and should be fitted to both the foot size and leg circumference. They may also be obtained in various lengths, some reaching to just below the knee, others to the groin. It is important that the length be sufficient to cover the uppermost varicosity. The stocking must be held up by a garter belt or girdle. The most satisfactory bandages are made of elastic webbing and are three inches wide and three yards long. In applying the bandage, one or two turns should be made around the foot to anchor it, and then it is wound in a tight spiral around the ankle and up the leg to a point slightly above the highest varicosity. The upper end is fastened by a safety pin. Whether the stock- ing or bandage is used, it is worn all day and removed at bedtime. Both are washable.