The Effect of Pregnancy on the Lower-limb Venous System of Women with Varicose Veins

Abstract

Objectives to assess the effect of pregnancy on the lower-limb venous system of women with varicose veins. Design a longitudinal prospective study of 11 pregnant women, with varicose vein disease. Methods eleven pregnant women with varicose veins were recruited as part of a larger study. Veins were assessed in both lower limbs using colour-flow duplex scanning at a 75° head-up tilt. The diameter and velocity and duration of reflux were measured in each vein at 12, 20, 26, 34, 38 weeks gestation and 6 weeks postpartum. Results eleven women had reflux and varicose veins demonstrated at first scan. All veins dilated with increasing gestation. This was maximal in the superficial system, reaching significance (p≤0.05) in the right long saphenous, superficial femoral and posterior tibial veins, left long and short saphenous, popliteal, peroneal, anterior and posterior tibial veins. The velocity of reflux increased while the duration decreased with increasing gestation. This was most obvious in the long saphenous veins but did not reach statistical significance.Conclusions maximum changes were seen in the superficial venous system in the thigh. The effect was more pronounced on the left and the changes in reflux returned to pre-pregnancy levels in the puerperium.