Pregnant Legs

Kelly Anne Spratt, D.O., Director of Women's Cardiovascular Health at the University of Pennsylvania Presbyterian Medical Center, answers your questions.

Q. I am 26 years old and 5-1/2 months pregnant. I am developing varicose veins in my upper thigh. My friend says to wear support hose, but I have heard that support hose are no longer recommended because they are too tight. What should I do?

A. The changes you describe may or may not be varicose veins. They may be spider nevi, or telangiectasias, which are very tiny veins that become more apparent as a result of the hormonal changes of pregnancy. They may fade and disappear after delivery; if they don't, they can be removed by small injections of salt water or laser treatments.

Varicose veins are larger, more bulging, and due to weakness of the vein wall or weakness of the valves within the veins coupled with the increased pressure on the pelvic veins as the uterus grows.

Both telangiectasias and varicose veins tend to worsen with each subsequent pregnancy, so it would be wise to take measures to minimize them now. Wearing support hose is an excellent recommendation to minimize the ability for the veins to dilate -- and the "support" part actually helps the pumping action of the leg muscles. You will notice a big difference in the "tiredness" of your legs after a day in support hose versus socks or regular stockings!

Put them on before getting out of bed in the morning (before blood pools in your legs) and remove them at night before going to bed.

These tips will also help you minimize the appearance of spider nevi or varicose veins, and help minimize swelling in your legs and ankles:

  • Avoid long periods of standing or sitting. When standing for longer than 10 or 15 minutes, alternate putting one foot, then the other, up on a low stool.
  • When sitting, elevate your legs above the level of the hips when possible.
  • When lying down, raise your legs by placing a pillow under your feet, or lie on your side, not flat on your back.
  • Avoid restrictive clothes such as tight belts, girdles, or even panty-leg girdles designed for pregnancy.
  • Get some exercise such as a brisk 20- to 30-minute walk every day (exercise pumps blood back to the heart, preventing pooling in the legs).
  • Finally, don't smoke, since this also affects the small veins and decreases the collagen in your skin, making small veins more noticeable.