The reason for the prevalence ofis due to the fact that the pregnant woman has more blood in circulation than a non-pregnant woman, and because of this, the blood vessels may become dilated. This change is especially noticeable in the veins of the legs which become increasingly prominent as pregnancy advances. In many women, one or two veins may become so dilated and prominent as to warrant the label ‘varicose’.
A varicose vein is simply a vein which has become stretched and dilated to carry more blood. Most varicose veins that occur in pregnancy will disappear in two or three months after delivery, but one or two may persist and require treatment.
This is especially true of women who have had a number of pregnancies with only a short space between each. Whilst it is true that there is a familial tendency to varicose veins, so that if a woman’s mother has varicose veins she is more likely to get them herself, no-one, nowadays, need have the sort of varicose veins which were common twenty years ago. The important preventive measures for varicose veins in pregnancy are:-
- Avoid being on your feet for too long periods -two separate half days’ shopping are better than one long day trudging around with little rest. When sitting down, especially in the second half of pregnancy, put your feet up so that the veins are relieved to some extent of the pressure on them.
- Avoid constricting garters or elastic-topped stockings or socks.
- If varicose veins seem to be developing, consult the doctor or midwife about the advisability of wearing support stockings. Properly fitted elastic stockings provide the best support, but they are rather hot and unsightly. Reinforced nylon stockings or tights are often a reasonable compromise.
- If varicose veins are still present three months after delivery, consult the doctor, or, better still, a varicose vein specialist. The treatment of mild varicose veins is, of course, easier than the treatment of the more advanced kind. For this reason, it is important not to let mild varicose veins become severe. Seek advice on treatment before embarking on the next pregnancy.
Varicose veins of the vulva
Occasionally, vulval varicose veins appear in late pregnancy, either on their own or in association with varicose veins of the leg. They cause a good deal of aching discomfort. They appear as an irregular swelling on one of the labia majora and are most noticeable when the expectant mother is on her feet for any length of time. The swelling and discomfort quickly subside when she lies down.
Rest is the only satisfactory treatment for it is not possible to give support to the vulva and supporting tights do not usually give much relief. Fortunately, these uncomfortable and irritating veins do not cause any difficulty during delivery and disappear completely, without treatment, shortly after delivery.
Small Varicose Veins
Very small veins in the legs, known as venules, may become dilated and cause small patches of blue tracery which can look rather unsightly. (Support stockings do not, unfortunately, make any difference.) They do, however, disappear almost completely as soon as the pregnancy is over.
Ruptured Varicose Veins
Very occasionally a varicose vein ruptures during pregnancy, and the bleeding can be very alarming. The way to stop the bleeding is not to bend over and apply pressure to the bleeding point, but to lie down and elevate the leg in the air. This empties the vein and the bleeding stops at once. Having taken this measure, a doctor should, of course, be consulted.
Piles are varicose veins situated at the entrance to the anus (back passage). They often develop in late pregnancy and can be very uncomfortable, especially in the first few days after delivery when they are usually at their most prominent. In most cases, like varicose veins in the legs, they disappear completely within three months after delivery. They are worse after long periods of standing and are improved by lying down.
Constipation also aggravates them and may cause bleeding when hard faeces are passed. The constipation can be eased by including bran cereals, wholemeal bread, fresh green vegetables, etc. In the diet.
By avoiding prolonged standing and constipation, the discomforts of piles can be reduced, but if they are troublesome the doctor or midwife should be consulted. Soothing ointments and suppositories will help. If piles persist for longer than three months after delivery, a doctor or preferably a specialist in piles should be consulted. A good time to mention this problem to your doctor is at the post-natal check-up.
An anal fissure is a crack in the skin of the anus. Because it causes local discomfort and bleeding it is sometimes mistaken for a pile. It most commonly occurs after delivery and characteristic symptoms are pain and bleeding on passing a motion. It can easily be treated by suitable local applications or a simple surgical procedure. If it does not quickly clear up on its own, seek the doctor’s advice.
Prevention is always better than cure so if you take the above advice then you should be able to minimize.