Varicose veins of the small pelvis in women are characterized by their increase in diameter and tortuosity. Most often, this condition is associated with dysfunction of the venous valves. Despite its rather high prevalence, this disease is rarely diagnosed.
This is due to the variety of symptoms, the main one of which is always pain. It is typical of gynecological, neurological, gastrointestinal pathologies. VVMT is sometimes masked by diseases of the musculoskeletal system, especially radicular syndrome and osteoarthritis of the hip joints.
Description and reasons
Dilated veins in the pelvis are not always visualized, as they are often found deep under the skin. This is one of the reasons for the complexity of diagnostics. With VVMT, the elasticity and tone of the veins decrease, the blood circulates worse and begins to stagnate. As a result of the blockage and distension of the veins, an obstruction is created for the outflow of blood.
At the heart of the mechanism of VVMT is the failure of the valves of the veins of the ovaries, due to which the blood flows back and reflux occurs. This leads to an increase in intravenous pressure and stagnation of blood, as well as the formation of additional circles of blood circulation - collateral.
The most important trigger is dysplasia, an underdevelopment of connective tissue that affects about one third of the population. Dysplasia is a congenital defect in which the level of collagen necessary for vascular strength is reduced.
In the postmenopausal period, the severity of varicose veins decreases, which testifies in favor of the theory of hormonal influence on the state of the veins.
Progesterone - the female sex hormone, also called "pregnancy hormone", can significantly weaken the tone of the venous system. On the one hand, it reduces uterine tone, thereby preventing miscarriage, and on the other hand, it weakens the walls of blood vessels and causes them to expand. The situation is aggravated by the growth of the uterus, which presses more and more on the large veins and causes the formation of collateral blood flow bypasses. This is why VVMT is very common during pregnancy.
Increased risk factors for varicose veins include:
- physical activity that is too high or, conversely, insufficient;
- multiple pregnancy;
- multiple or complex birth;
- gynecological diseases - endometriosis, fibroids, etc. ;
- long-term use of steroid hormones, including contraceptives.
Types and degrees
Varicose veins in the small pelvis are of two types. The first type is called varicose veins of the vulva and perineum, the second is pelvic venous congestion syndrome. Both types can develop in isolation or combine with each other, which happens more often. Pregnant women mainly face vulvar venous lesions, which in more than 91% of cases disappear on their own after delivery.
BPVMT is also classified by origin and location. By origin, varicose veins are divided into primary and secondary. Primary varicose veins develop due to insufficiency of the venous valves. Pregnancy becomes its trigger. Secondary varicose veins are caused by systemic diseases.
In terms of location, the VVMT is total, when all the veins of the small pelvis are affected and partial, selectively involving one or more veins. Depending on the diameter of the veins, 3 degrees of severity are distinguished:
- 1 tbsp. - up to ½ cm;
- 2 tbsp. - 0, 6 - 1 cm;
- 3 tbsp. - more than 1 cm.
Symptoms of varicose veins include:
- painful distension and heaviness in the lower abdomen;
- increased number of secretions;
- various urinary disorders;
- rapid weight gain already at the beginning of gestation.
Pain, as a rule, increases after sexual intercourse, hypothermia, long walks or standing. If the superficial veins in the genitals and upper thighs are affected, bluish-red veins and vascular network may appear.
Often the signs of varicose veins resemble cystitis: intensely painful urination in small portions.
Towards the end of pregnancy, a burning sensation and swelling in the genitals may occur. Such a symptom requires special attention, since the development of inflammation or rupture of the veins is possible, which can lead to severe bleeding.
What is the danger of BPVMT
Varicose veins can cause several life-threatening complications. First of all, this is thrombophlebitis or thromboembolism - an inflammation of the dilated veins, which leads to the formation of blood clots. If a blood clot - a thrombus - blocks a vessel, the blood supply to the placenta will be blocked. The result of the blockage will be placental insufficiency and fetal hypoxia.
Another serious complication is the threat of miscarriage and premature birth due to poor circulation.
Because of dilated veins, doctors may not allow natural childbirth to minimize the risk of rupturing the veins, resulting in internal or uterine bleeding.
In pregnant women, drug therapy is limited to the intake of phlebotonics and antithrombotic drugs. With severe pain, it is permissible to use drugs from the group of non-steroidal anti-inflammatory drugs (NSAIDs). If there is a threat of oxygen starvation of the baby, the treatment is carried out in a hospital setting with the use of antihypoxic drugs.
From the fourth month on, a phlebosclerosis surgery can be performed, during which a venosclerosis is injected into the affected veins. The effect of the procedure is evaluated after 7 days, if necessary, repeat it. Compression garments should be worn for the whole week after surgery. It is possible to achieve involution of veins in one session, but more often it is necessary to carry out 3-4 phlebosclerosis procedures.
Persistent pain syndrome and a large diameter of varicose veins greater than 1 cm is an indication for surgery. It can only be performed in the first 2 trimesters of pregnancy with gentle methods of laser or radio wave coagulation. If the EMCT is caused by retroflexion of the uterus, plastic surgery is performed on the uterine ligaments.
Doctors advise pregnant women diagnosed with varicose veins of the pelvis to move more and exercise to prevent blood from pooling in the pelvis. Wearing a compression bandage and diet will help slow the progression of the VVMT.
The menu must be composed in such a way that it contains mainly plant foods, as well as fermented milk products and cereals in sufficient volume.
An increasing contrast or perineal shower gives a good effect. During the procedure, the woman sits on a special ring-shaped seat, water is supplied from below and directed to the perineum. The duration of the procedure is 3-5 minutes, the course of treatment includes from 15 to 20 sessions.
Preventing the development and progress of varicose veins comes down primarily to optimizing physical activity and nutrition. The most important thing is to eliminate prolonged static and dynamic loads, as well as adjust the diet, introduce more fruits and vegetables into the diet. In the initial stages of varicose veins, physical therapy and breathing exercises will help the use of compression knitwear.