No sense in standing when you can sit...
we Treat varicosity after the delivery of
It is known that pregnancy is risk factor of development of a varicose illness: often during incubation of the kid “snakes“ of expanded veins or vascular “asterisks“ standing appear. However to future mothers to treat this illness it is problematic - it is only possible to take the measures interfering progressing of a disease. And here after the delivery it is a high time to give diseases worthy repulse, now the woman has an opportunity to use for this purpose all arsenal of remedies.
the Word “varicosity“ comes from the Latin word “varix“ - swelling. The varicosity is the chronic disease which is followed by various violations of outflow of blood in veins connected with pathological changes in venous valves that quite often causes changes in all vascular system.the Problem of a varicose illness is known to
since Hippocrates and Avicenna who devoted the whole sections of the works to the description and treatment of diseases of veins. In Russia more than 35 million people have a varicose illness, at the same time women are subject to much bigger number of risk factors, in comparison with men. The problem of a varicose illness is especially actual for women during pregnancy and during the early postnatal period, especially if the disease arose even before pregnancy.
As the disease arises?to
to deal with a problem of a varicose illness, it is necessary to present how the venous system of legs is arranged and as there is an outflow of a blue blood.
the Venous system of the lower extremities consists from superficial and deep. Superficial veins are located directly under skin, deep - in a muscular layer of a shin and hip. Connection between these two systems is provided by kommunikantny (perforantny) veins. In each vein there are valves providing a blood-groove only in one direction - from the periphery to the center.Current of a blue blood to heart is provided to
with reduction of a cardiac muscle, muscles of a shin and hip (muscular pomp). One more necessary factor is full operation of venous valves which, similar to heart valves, promote blood passing only in one direction. At reduction of muscles of a shin and hip there is a sdavleniye of deep veins of an extremity, and blood from them comes to veins of a shin and a hip, and also to basin veins. Not changed valves of veins do not allow blood to get into superficial venous system. If valves of deep veins work normally, at relaxation of muscles of return of blood from veins there is no basin.Increase of pressure in basin veins due to growth and development of a fruit leads
to gradual destruction of valves of veins therefore at muscular contractions blood under big pressure comes from deep venous system to superficial. Increase of pressure in superficial veins leads to their expansion. This state is also called a varicosity. In separate group of displays of this disease it is possible to allocate so-called vascular asterisks which arise from - for expansions of venous capillaries of skin and hypodermic cellulose. They can be congenital and acquired, being shown in any place on skin of the person. But if they appeared on skin of legs, actively increase, then they should be regarded as a symptom of the beginning varicose illness.
Symptoms of a varicosity
of Display of varicosity depend on an illness stage. At the beginning of a disease when there did not come irreversible changes in vessels and capillaries yet, “worms“ of expanded veins standing can be the only symptom. In process of progressing of an illness there are a fatigue, feeling of weight in legs, a raspiraniye, spasms in gastrocnemius muscles (especially by the evening, and sometimes and at night), a sleep, feeling of a pricking. Hypostases usually arise by the evening, especially after long standing or sitting, and after night rest completely disappear. Over time, in process of progressing of a varicosity and destruction of valves of veins, there are trophic violations (they are connected with deterioration in receipt to fabrics of oxygen and other substances) - more often they arise on an internal surface of the lower third of a shin. It is an induration (hardening, consolidation of skin), pigmentation, dermatitis (emergence of sites of an inflammation on skin), then - the trophic ulcer which is badly giving in to treatment.
the Greatest danger is constituted by not a varicose illness, but its complications which treat:
- thrombophlebitis - an inflammation of veins;
- the trophic ulcers resulting from sharp deterioration in blood supply of skin;
- a thrombembolia - formation of blood clots in veins of different diameter, obstruction of a gleam of veins, including large pulmonary veins.
As it was mentioned above, these complications most often arise at persons with the increased intra belly pressure which also pregnant women treat. However it is necessary to remember that increase of intra belly pressure at pregnant women - a temporary phenomenon and comes it gradually.
in the absence of a varicose illness before pregnancy and at the correct behavior during pregnancy and after the delivery display of a disease disappear. But, as we already know, it is easier to warn or reveal an illness at early stages (compensation stage), than subsequently to treat her the started forms.at
to suspect at itself a varicose illness of the lower extremities, it is enough to look on the legs and to listen to the feelings. In a stage of compensation of a varicose illness when the system of deep veins is not mentioned, works in the usual mode and there are manifestations only from superficial veins, it is possible to notice insignificant expansion of hypodermic veins: they are soft, are easily fallen down, skin over them is not changed. In a decompensation stage (in this stage there are already changes of the valvate device and deep veins) moderate or sharp expansion of hypodermic veins is defined; they are dense, sometimes painful, skin over them gets the pigmented shade (red, cyanotic or bagrovo - brown).
If you before pregnancy found at least one of the listed signs, it is necessary to visit the phlebologist or the vascular surgeon. And if such opportunity does not exist, then address the surgeon of policlinic at the place of residence.
the Varicose illness can warn, knowing about risk factors which promote its emergence and development:
- hereditary predisposition;
- of feature of an anatomic structure and blood supply of legs;
- application of hormonal contraceptives of old generation (the medicine with high content of hormones contributing to varicosity is not sold now);
- hard physical work;
- long stay in sitting or vertical position;
- the reduced physical activity during pregnancy;
- chronic diseases of intestines, locks;
- chronic diseases of lungs with the long exhausting cough.
Thus, among risk factors are what we cannot affect (for example, heredity), but is also such which to exclude quite in our forces.
For example, it is not necessary to stand or sit long in one pose. It is not necessary to face a bathroom or a basin, washing diapers and baby`s undershirts of the kid: this process can quite be entrusted the washing machine.
of Walk with the child will be executed by a role of feasible physical activity and charging. But at the same time it is not necessary to go to exhaustion or, on the contrary, for hours to sit with the book, comfortably having settled on a shop.
As high heels are also risk factor of progressing of varicosity, it is worth refusing them, whenever possible.
After the delivery the woman can remain or have a problem of locks: its decision also belongs to measures of prevention of a varicose illness.
exists a huge arsenal of methods of diagnosis of a varicose illness Now. They are available and do not cause any unpleasant feelings. Treat the most widespread and reliable methods:
- of ultrasonic doppler sonography - the simplest and safe method when by means of ultrasound blood-groove speed in superficial and deep venous systems is defined; to
- angioskanirovany - the method is similar to ultrasonic doppler sonography; it allows to define more precisely degree of venous insufficiency in vessels of small caliber and capillaries; the contrast rentgenoflebografiya - allows to reveal
- at what level there was a defeat of the valvate device of superficial and deep veins, by contrast introduction (a special preparation) and its movement on the vascular course.
the simplest and not demanding special time expenditure measures which can be applied after the delivery if you had a varicosity during pregnancy, are:
- of wearing elastic stockings or bandage in the afternoon;
- observance of the mode of physical activities and rest;
- complex of remedial gymnastics.
needs to Carry elastichesky jersey the entire period of pregnancy and about a month after the delivery that will prevent violation of operation of valves of veins.
In an arsenal of a modern flebologiya is available enough methods of treatment of a varicose illness of legs. These ways are divided into medicamentous (conservative) and surgical (quick).
women with a varicosity after the delivery can have such complication as thrombophlebitis - formation of blood clot, an inflammation of a venous wall.the Inflamed veins are strained, painful
at palpation, skin over an affected area red, temperature increases to 37,5 º The PageTreatment is carried out by
in a hospital. The patient is necessary a bed rest, sublime position of legs; use the antibiotics, sulfanylamides, preparations possessing anti-inflammatory properties (Esku - Zahn, Butadion, Acetilsalicylic acid), and also anesthetics. Treatment (protivo - the curtailing preparations) do not begin with anticoagulants 3 earlier - go day after the delivery from - for dangers of uterine bleeding.
to full treatment, but is capable to lead at early stages to disappearance of many displays of an illness, and on late - considerably to facilitate a condition of the patient.Conservative methods include
- of Elimination of risk factors.
- Reception of medicines. Today one of the main preparations used for treatment of a varicose illness Detra - Lex is considered. It is well soaked up from zheludochno - an intestinal path, does not cause any side effects, makes very good medical impact. As an additional tool it is possible to accept Trental (similar preparations - Foams - toksifillin, Pentillin, the Agape feast - Rihn) on 1 tablet 2 times a day within 4 weeks and Askorutin on 1 tablet 2 times a day within 4 weeks.
- Use of medicinal ointments and gels. can carry To such preparations Lioton - gel which is rubbed in the affected shin by 3 times a day within 4 - 5 weeks. Possibly in an initiation of treatment to apply Geparinovuyu ointment, applying it 2 times a day on the affected shin within 7 - 10 days, with the subsequent transition to Lioton - gel.
- Physical therapy. It is carried out in the conditions of a physiotherapist`s office on an outpatient basis (a magnetotherapy, diadynamic currents (DDT) on lumbar area, Bernard`s currents) - physiotherapeutic procedures improve blood circulation in a vascular wall, strengthen it.
- Massage. recommend quiet strokings and weak razminaniye of fingers, feet, shins in the evenings and before going to bed. It is good that during a dream of a leg were in the raised situation: there will be thus a natural outflow of blood from stagnant and edematous sites.
- Remedial gymnastics. the Basis of a complex is made by the following exercises:
- “Bicycle“ lying on a back 2 - 3 times a day.
- Rolling from heels and rise on socks.
- Daily walking not less than 3 - 4 hours a day and if the state, jogging, driving the bicycle or occupations on the exercise bike allows.
All listed preparations, procedures and exercises it is possible to use during the postnatal period including when feeding by a breast.
needs Separately to mention injection and laser sclerotherapy which are very seldom used as an independent method, but give good effect in complex treatment of a varicose illness in any its stage. The essence of a method consists in introduction in varikozno the changed vein of special medicine which leads to emergence of artificially caused inflammation in a gleam of a vessel and to the subsequent its obliteration (adhesion). This method is applied in a complex with all other methods of treatment, however in hands of the inexperienced surgeon is capable to cause very serious complications which cannot be eliminated even in the surgical way. This method is recommended to be used upon termination of the breastfeeding period.
the Main objectives of a surgical method of treatment is removal varikozno of expanded veins and restoration of normal outflow of a blue blood from the lower extremities. In order that operation took place successfully, it is necessary to conduct the fullest complex of examinations. Enter their number:
- General blood test.
- Coagulability, bleeding, a koagulogramm - the analyses used for definition of a condition of the curtailing system of blood.
- of ultrasonography of abdominal organs.
- Ultrasonic doppler sonography. Angioskanirovaniye`s
- Contrast rentgenoflebografiya.
After receiving and an assessment of all results of inspection resolves an issue of need of expeditious treatment and the choice of its method. As it was already noted earlier, in an arsenal of modern surgery there is a set of ways of expeditious treatment.
K the most widespread belong:
- of Removal of all varikozno the changed vein. This type of operation is applied in the started cases when there are already irreversible changes of skin, trophic ulcers, limfostaz. Unfortunately, an operation is undergone rather hard, after it rather big percent of recurrence is possible.
- Limited bandaging with a proshivaniye of insolvent perforant and the subsequent flebosklero - a zirovaniye. Such opportunity exists if there is limited varicosity and on ultrasound insolvency of the perforantny veins connecting system of deep and superficial veins is revealed.
These operations are performed upon termination of the breastfeeding period.
Drug and surgical treatment should be begun before pregnancy (if the illness already exists) or after the delivery not earlier than the end of the period of feeding with a breast and a complete recovery from a female genital. And during pregnancy, especially in its late terms, and during the postnatal period as it was already told, carrying medical jersey, elimination of risk factors, remedial gymnastics are necessary. And if you follow all these rules that is not difficult at all, then a varicose illness and its complications do not threaten you.