Pregnancy is often regarded as a time of great joy and anticipation, yet it brings significant physiological changes that can pose serious risks to a woman’s vascular health.
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Pregnancy is often regarded as a time of great joy and anticipation, yet it brings significant physiological changes that can pose serious risks to a woman’s vascular health.
According to Dr Vinesh Padayachy, a leading vascular surgeon based at the Lenmed eThekwini Hospital and Heart Centre in Durban, expectant mothers must be aware of the vascular challenges that can arise during pregnancy and take proactive steps to mitigate these risks.
How Pregnancy Affects the Vascular System
The human body undergoes an extraordinary transformation during pregnancy, including an increase in blood volume by up to 50% to support the growing foetus. However, these changes place additional strain on the circulatory system.
“Pregnancy triggers major adjustments in the vascular system,” explains Padayachy.
“The surge in blood volume and hormonal fluctuations cause blood vessels to widen, leading to lower blood pressure. At the same time, the uterus exerts pressure on major veins, slowing blood return from the legs to the heart. This can contribute to complications such as varicose veins, deep vein thrombosis (DVT), and swelling (oedema).”
The Most Common Vascular Complications in Pregnancy
While many women experience mild discomfort, some develop more severe vascular conditions that pose risks to both mother and baby.
One of the most serious concerns is Deep Vein Thrombosis (DVT), where a blood clot forms in a deep vein, typically in the legs. Pregnancy creates a hypercoagulable state, meaning the blood becomes more prone to clotting — a natural defence mechanism against excessive bleeding during childbirth but a significant risk factor for thrombosis.
“Hormonal changes, venous stasis due to uterine pressure, and reduced mobility — especially for women on prolonged bed rest — an increase the risk of life-threatening blood clots,” warns Padayachy. “If left untreated, a clot could travel to the lungs, causing a pulmonary embolism, which can be fatal.”
Other vascular complications include varicose veins and chronic venous insufficiency, conditions that develop due to increased venous pressure. While these are often harmless, Padayachy advises expectant mothers to watch for sudden, painful swelling, skin discolouration, or intense leg pain, as these could signal a more serious vascular issue.
Another life-threatening condition, preeclampsia, is marked by high blood pressure and damage to organs such as the liver and kidneys. “Preeclampsia is fundamentally a vascular disorder,” explains Padayachy.
“It involves endothelial dysfunction, where the blood vessels fail to regulate blood flow properly. This increases the risk of stroke, cardiovascular disease, and future pregnancy complications.”
Women with gestational diabetes also face heightened vascular risks. High blood sugar levels can damage blood vessel walls, leading to hypertension, blood clots, and reduced circulation.
“Gestational diabetes not only affects pregnancy but also increases the long-term risk of developing Type 2 diabetes and cardiovascular disease,” warns Padayachy.
Prevention and Early Detection
To reduce the likelihood of vascular complications, pregnant women should adopt a proactive approach to their health.
“Regular physical activity such as walking or swimming can promote healthy circulation, while a diet rich in fibre, omega-3 fatty acids, and minimal processed sugars supports vascular function,” advises Padayachy.
“Staying hydrated and wearing compression stockings can also help prevent DVT and varicose veins.”
Screening for vascular risks is also crucial. Padayachy recommends Doppler ultrasound scans to assess blood flow and detect clots early, alongside routine blood pressure monitoring to catch signs of hypertension or preeclampsia. Women with a family history of clotting disorders may benefit from thrombophilia screening.
Postpartum Vascular Health: What Happens After Birth?
Many women assume that vascular complications resolve after delivery, but this is not always the case.
“Some conditions, like varicose veins and chronic venous insufficiency, may persist and require long-term management.
“Preeclampsia-related hypertension, if not carefully monitored, can develop into chronic high blood pressure or cardiovascular disease later in life.”
As a result, he strongly encourages new mothers to undergo postpartum vascular health assessments, particularly if they experienced hypertension, DVT, or gestational diabetes during pregnancy.
Advancements in Vascular Medicine for Expectant Mothers
Thankfully, modern medicine has seen significant advancements in the detection and treatment of pregnancy-related vascular issues.
“We now have minimally invasive treatments like endovenous laser therapy (EVLT) for varicose veins, which allow for quicker recovery times. Improved anticoagulant therapies, such as low molecular weight heparin (LMWH), provide safer options for pregnant women at risk of DVT,” explains Padayachy.
“Non-invasive Doppler imaging has also enhanced our ability to detect vascular abnormalities early.”
While pregnancy presents incredible physiological challenges, being informed about potential vascular risks can help women take proactive steps towards a healthier journey.
“The key is awareness and early intervention,” stresses Padayachy.
“Expectant mothers should not dismiss persistent swelling, pain, or high blood pressure, as these could be warning signs of serious vascular complications. With the right monitoring, lifestyle adjustments, and medical care, we can significantly reduce the risks and improve outcomes for both mother and baby.”
For women who are pregnant or planning to conceive, consulting with a vascular specialist can be an essential step in ensuring a safe and healthy pregnancy.
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