Varicose Veins & Pregnancy

We would like to congratulate anyone who is pregnant and reading this page. Pregnancy puts substantial stresses on the venous system. In susceptible individuals, this can lead to:

  • The development of venous disease for the first time.
  • Unmasking of subclinical venous disease (venous disease that was present but not visible).
  • The deterioration of pre-existing venous disease.

Pregnancy contributes to the development or exacerbation of venous disease by several mechanisms.

Increase in circulating blood volume:

Normally most of the circulating blood volume at any one time resides within the veins. The total blood volume increases with pregnancy. To accommodate this larger volume of blood, the veins become more dilated.

Increase in cardiac output:

This is the measurement of the volume of blood that is circulated around the body by the heart per minute. The entire volume of blood that is pumped around the body needs to be returned by the veins. A larger cardiac output therefore requires the veins to work harder to return a higher volume of blood back to the heart.

Decrease in venous tone:

Progesterone causes the veins to become more dilated in pregnancy.
Impaired venoarterial reflex:
Progesterone impairs this normal reflex of the venous system.
Impaired venous return:
In the third trimester of pregnancy, the pregnant uterus can compress the inferior vena cava (a large vein that carries blood from the lower body, including the legs, back to the heart).
All these physiological changes help to explain why women often report that their veins become very noticeable during pregnancy. This may take the form of spider veins, bulging varicose veins, or even vulval varicosities.

Pregnancy and vein treatment

In general, varicose veins should not be treated during pregnancy. Your veins are likely to get worse throughout the pregnancy however there is often a degree of improvement in the months after giving birth.
For those with pre-existing spider or varicose veins and who are planning a pregnancy, it may well be worthwhile having your veins treated before becoming pregnant. There are some advantages with this approach. The complications of varicose veins are often proportional to the duration of venous disease. Such potential complications can be avoided by having the veins treated before pregnancy. Treatment is often less complicated when the venous disease is less advanced.