Compression in Pregnancy
Dr Marcondes Figueiredo
Why do pregnant women have more propensities to varices?
The incidence of varices in this period is 24% in primiparas (first child) and from 50 to 76% in multiparas (from the second child on). A number of factors cause varices during pregnancy, such as the hormonal, mechanical, hereditary predisposition, physiological changes of the pelvic circulation and increase in blood volume.
The hormonal factor is the most relevant in the emergence of varices during pregnancy, since 2/3 of them appear already in the first three months of the pregnancy. Eventually, the appearance of vulvar varices in the first quarter of pregnancy may be ascribed to the volume of the uterus. There is also an increase in the uterine blood flow during pregnancy, causing the iliac veins to ingurgitate, causing difficulties to the draining capacity of lower limbs veins.
What are the symptoms of venous diseases during pregnancy?
Symptoms vary according to the case, depending on the seriousness of the venous disease. Leg pain is the most important symptom. Its intensity hinges on several factors, such as weight and tiredness and, eventually, there may be also burning on the extremities.
Edemas affect 50% of pregnant women, but they are not always related to varices. They usually comes up in the last few months of pregnancy and are more intensive in the evening, improving in the morning or with rest.
What steps should the pregnant woman take?
In order to prevent the pathology from occurring, it is necessary to: avoid excessive weight gain through a balanced diet; practice water aerobics or just walk inside a swimming pool 2 to 3 times a week; practice stretching and flexibility exercises, which improves breathing and posture; undergo lymphovenous draining of the lower limbs 2 to 3 times a week, with mobilization of the joints in order to help phlebodynamics.
In case of intensive evening swelling, interspersed rest is recommended: for each 2 hours standing, the patient should lie down or, if sitting, raise his/her legs, for 1 hour.
What are the advantages of wearing elastic stockings during pregnancy?
Wearing elastic stockings lessens the pain and swelling caused by varices. Elastic stockings should be determined under orientation of a doctor prescription according to the model: ¾, 7/8 or pants; the compression in millimeters of mercury (mmHg); the size, based on morning measures, according to the ankle, calf and thigh diameters.
Compress therapy is always possible and, in many cases, the only therapy available. It practically does not present counterindications or side effects.