Varicose veins of the pelvis in women are characterized by an increase in diameter and curvature. This condition is most often associated with venous valve dysfunction. Despite its relatively high prevalence, this disease is rarely diagnosed.
This is due to a variety of symptoms, the main of which is always pain. It is characteristic of gynecological, neurological, gastrointestinal pathologies. VVMT is sometimes disguised as a disease of the musculoskeletal system - in particular radicular syndrome and osteoarthritis of the hip.
Varicose veins in the pelvis are not always visualized, as they are often located deep under the skin. This is one of the reasons for the complexity of the diagnosis. With VVMT, the elasticity and tone of the veins decrease, the blood circulates worse and begins to stagnate. As a result of blockage and dilation of the veins, an obstruction to the flow of blood is created.
At the heart of the mechanism of VVMT is the failure of the valves of the ovarian veins, due to which the blood flows back and reflux occurs. This leads to an increase in intravenous pressure and blood stasis, as well as the formation of additional circulatory circuits - collateral.
The most important trigger is dysplasia, an underdevelopment of connective tissue that affects about a third of the population. Dysplasia is a congenital defect in which the level of collagen needed 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 condition 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 the tone of the uterus, thus preventing miscarriage, and on the other hand, weakens the walls of blood vessels and causes them to dilate. The situation worsens with the growth of the uterus, which increasingly compresses large veins and provokes the formation of bypass pathways of blood flow, collateral. That is why VVMT is very common during pregnancy.
Increased risk factors for varicose veins include:
Varicose veins in the pelvis are of two types. The first type is called varicose veins of the vulva and perineum, the second is the syndrome of pelvic venous congestion. Both types can develop in isolation or combine with each other, which is the most common. Pregnant women face mainly vulvar venous lesions, which in more than 91% of cases disappear on their own after birth.
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 his trigger. Secondary varicose veins are caused by systemic diseases.
In terms of localization, EMCT is total when all pelvic veins are affected, and partial, selectively affecting one or more veins. Depending on the diameter of the veins, there are 3 degrees of severity:
Symptoms of varicose veins include:
The pain usually worsens after intercourse, hypothermia, prolonged walking or standing up. If the superficial veins in the genitals and upper thighs are affected, veins and a bluish-red vascular network may appear.
Often the signs of varicose veins resemble cystitis: sharp painful urination in small portions.
Towards the end of pregnancy there may be a burning sensation and swelling of the genitals. This symptom requires special attention, as it is possible to develop inflammation or rupture of the veins, which can lead to heavy bleeding.
Varicose veins can cause several life-threatening complications. First of all, it is thrombophlebitis or thromboembolism - inflammation of varicose veins, leading to the formation of blood clots. If a blood clot - a blood clot - clogs a vessel, the blood supply to the placenta will be blocked. The result of the obstruction will be placental insufficiency and fetal hypoxia.
Another serious complication is the threat of miscarriage and premature birth due to poor circulation.
Due to varicose veins, doctors may not allow natural childbirth to minimize the risk of rupture of the veins, leading to internal or uterine bleeding.
In pregnant women, drug therapy is limited to phlebotonics and antithrombotic drugs. In case of severe pain, it is allowed to use drugs from the group of non-steroidal anti-inflammatory drugs (NSAIDs). If there is a threat of oxygen starvation of the child, treatment is carried out in a hospital setting using antihypoxant drugs.
From the fourth month, phlebosclerotic surgery can be performed, during which venosclerosis is injected into the affected veins. The effect of the procedure is assessed after 7 days, if necessary, repeat it. Compression garments should be worn throughout the week after surgery. It is possible to achieve involution of the veins in one session, but more often it is necessary to perform 3-4 procedures for phlebosclerosis.
The syndrome of constant pain and large diameter of varicose veins over 1 cm is an indication for surgery. It can be performed only during the first 2 trimesters of pregnancy by gentle methods of laser or radiowave coagulation. If VVMT is caused by uterine retroflexion, plastic surgery of the uterine ligaments is performed.
Pregnant women diagnosed with varicose veins of the pelvis are advised by doctors to move more and do exercises to prevent blood stasis in the pelvis. Wearing a compression bandage and diet will help slow the progression of VVMT.
The menu should be composed in such a way that it contains mainly plant foods, as well as fermented dairy products and cereals in sufficient volume.
Increasing contrast or perineal shower gives a good effect. During the procedure, the woman sits in a special seat in the form of a ring, the water is fed from below and directed to the perineum. The duration of the procedure is 3-5 minutes, the course of treatment includes 15 to 20 sessions.
Prevention of the development and progress of varicose veins comes down mainly to optimizing physical activity and nutrition. The most important thing is to eliminate prolonged static and dynamic loads, as well as to adjust the diet, to introduce more fruits and vegetables in the diet. In the early stages of varicose veins, exercise therapy and breathing exercises, wearing compression stockings will help.