How can I prevent varicose veins in pregnancy?
Are there other leg conditions that affect pregnant women?
At the time of your first
pregnancy you have a 20 per cent risk of developing problems with leg veins,
and this doubles with future pregnancies. Not just a venous thrombosis, but
also varicose, or spider veins. Men and women of all ages can develop varicose
veins, but the special changes in your body during pregnancy make you
especially susceptible to this condition. When you’re pregnant hormone changes
may cause vein walls to relax slightly and stretch out. Also, greater blood
flow to and from the womb, along with the size and weight of your expanding
tummy, puts additional pressure on the veins of your legs.
What is thrombosis?
A blood clot in the vein is called a venous
thrombosis, and an example of this is deep vein thrombosis (DVT) when a blood
clot occurs in a deep vein, usually in the leg. In a pregnant woman, a DVT is
most often found in the leg or the pelvis. The body has natural systems to stop
excessive clotting. Some people are born with a tendency for these systems not
to work properly. This gives them an increased risk of blood clots. Doctors
call this thrombophilia. Many deep venous thromboses in young women during
pregnancy are the first sign of an underlying thrombophilia. Often there is a
family history of thrombosis with relatives like mother, father, aunts and
uncles having been affected – and this can be passed down through the
generations. If you have already had a clot, or there is a family history of
clotting, you may be offered a blood test to determine if you have a
thrombophilia.
Why are there greater risks of blood clots during pregnancy?
Thrombosis can affect anyone, but being
pregnant makes your blood more likely to clot. Doctors believe that the changes
in clotting of the blood are designed to reduce bleeding at the time of normal
delivery. When you’re carrying a baby there is a dramatic reduction in the
speed of blood flow in your veins, which carry the blood from your legs back to
the heart. Doctors think that this is due to the effect of pregnancy hormones
on the veins and also because of the womb getting bigger as the pregnancy
advances. The reduction in blood flow becomes obvious in pregnancy by 16 weeks
and is at its most sluggish closer to full-term as your body gets ready for the
actual delivery. The blood flow does not return to normal until six weeks after
delivery. This sluggish flow in the veins is why many women get some swelling
of the legs when they are pregnant. It is this reduction in blood flow, combined
with the increased clotting tendency while pregnant that can result in a clot
in the leg. This condition can be prevented, and if it does occur, can be
treated.
Also, at the time of delivery, as the baby presses on the veins in the
pelvis, minor damage can occur to these veins leading to an increased risk of
having a clot for up to six weeks after delivery.
What are the signs of a venous
thrombosis – or DVT?

What if I’m pregnant and have had a previous venous thrombosis?
If you’ve suffered a venous thrombosis before, your risk of another will
be increased during and just after pregnancy. The risk is particularly
increased if no cause was found for the thrombosis, if you have had more than
one clot, or if you have a thrombophilia. Most doctors believe that women with
a previous clot should be tested for thrombophilia, which requires a simple
blood test. Ideally this should be done before you become pregnant. Once
pregnant you must inform your GP, midwife or obstetrician if you have had a
thrombosis or if there is a history of thrombosis in your family. If it is
considered that you have a high risk of thrombosis in pregnancy your doctor may
recommend that you take low molecular weight heparin injections all through the
pregnancy and after delivery. Graduated elastic compression stockings may also
be used, as they are very effective in preventing thrombosis. They may be used
on their own or combined with heparin injections.
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