Pregnancy & Vein Treatment
HIgh risk pregnancy specialist
weissj@ebpma.com
67.174.202.90 Submitted on 2009/09/01 at 4:29am
I have several pregnant patients who complain about painful varicose veins which have gotten worse during their pregnancy. Conservative measures – stockings, bedrest – have not appreciably improved their condition. Is sclerotheraphy or laser ablation safe and effective in pregnancy?
Author Comment In Response To
Author Comment In Response To
veindoc
whybevein.com
veindoc@comcast.net
24.4.160.18 Submitted on 2009/09/01 at 2:44pm
In general elective vein therapy, both scelerotherapy and endovenous laser, is avoided until approximately 3 months post delivery. This relates to the increase of clot forming during pregnancy and early postpartum. We certainly will evaluate pregnant patients with vascular ultrasound exams and rule out clots, phlebitis and inform patient what may need to be treated in the future. Much of the pregnancy related increase of surface spider and blue green reticular veins will regress quickly postpartum. Documented venous insufficiency of the main veins of the superficial venous system(greater & small saphenous veins) usually will require treatment in the future. Pregnant patients with vein related bleeding can be treated with elevation, compression, and rarely ligation performed with local anesthesia.
The good news for subsequent pregancies in patients with severe vein related pain and venous insufficiency is endovenous thermal ablation. The somewhat dated approach of suffering with leg vein pain until you are done having children now has better alternatives. In the past, the high recurrence rate & permanent leg scarring of surgical stripping and ligation made enduring multiple pregnancies with severe vein related leg pain very common. However, less invasive techniques with much lower recurrence and no downtime, make endovenous thermal ablation a truly viable option. It should be done electively between pregnancies. We have treated many patients who have benefited with minimal or no leg pain in future pregnancies.
Finally, for mothers who are breast feeding, sclerotherapy and endovenous laser can be safely done. For sclerotherapy a conservative approach is to pump prior to procedure and discard breast milk for perhaps 24 hours so as not impart a taste issue.
Thanks very much for your query.
