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Answer
Varicose veins occur due to a genetic predisposition to have weaker vessel
walls; increased pressure in pregnancy due to increased blood volume and
weight of the baby; and hormonal influence on the vessel wall that promotes
greater relaxation in the vessel, lower blood return, and greater pooling
in the lower extremities. If you have varicose veins, you are at increased
risk for developing superficial or deep vein clots in pregnancy.
Wearing support hose helps to improve the blood return and decrease the
risk of clotting. One important feature about wearing support hose is
to be sure you put them on before you stand up and all the blood rushes
to your lower extremities. When you shower or run to the bathroom in
the morning before putting on your support hose, return to bed, lie
down and place the soles of your feet against the wall higher than your
head for five minutes. This will allow the blood to return to your
trunk, then put your support hose on.
I encourage patients to see how the veins appear after having a baby.
In the first few weeks of the postpartum period you will be at
increased risk of clotting due to fluid volume and hormonal changes
that will influence the elasticity of the vessel walls. You should
discuss with your midwife if your varicosities are severe enough to
require use of TED hose during labor or in the postpartum period.
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