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Interventions for varicose veins and leg oedema in pregnancy

Authors: Smyth Rebecca M D, Aflaifel Nasreen, Bamigboye Anthony AJournal: The Cochrane database of systematic reviewsPublished: October 19, 2015DOI: 10.1002/14651858.CD001066.pub3
Q1 JournalSJR: 4.8h-index: 291SCImago
Moderate EvidenceSystematic Reviewn=326 participants

In Plain Language: pregnancy, explained

Pregnancy is presumed to be a major contributory factor in the increased incidence of varicose veins in women, which can in turn lead to venous insufficiency and leg oedema. The most common symptom of varicose veins and oedema is the substantial pain experienced, as well as night cramps, numbness, tingling, the legs may feel heavy, achy, and possibly be unsightly. Treatments for varicose veins are usually divided into three main groups: surgery, pharmacological and non-pharmacological treatments. Treatments of leg oedema comprise mostly symptom reduction rather than cure and use of pharmacological and non-pharmacological approaches. To assess any form of intervention used to relieve the symptoms associated with varicose veins and leg oedema in pregnancy. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 May 2015) and reference lists of retrieved studies. Randomised trials of treatments for varicose veins or leg oedema, or both, in pregnancy. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We included seven trials (involving 326 women). The trials were largely unclear for selection bias and high risk for performance and detection bias.Two studies were placebo-controlled trials. The first one compared a phlebotonic (rutoside) with placebo for the reduction in symptoms of varicose veins; the second study evaluated the efficacy of troxerutin in comparison to placebo among 30 pregnant women in their second trimester with symptomatic vulvar varicosities and venous insufficiency in their lower extremities. Data from this study were not in useable format, so were not included in the analysis. Two trials compared either compression stockings with resting in left lateral position or reflexology with rest for 15 minutes for the reduction of leg oedema. One trial compared standing water immersion for 20 minutes with sitting upright in a chair with legs elevated for 20

Key Findings: what this systematic review found about pregnancy

  • ✓Pregnancy is a major contributory factor in the increased incidence of varicose veins in women, which can lead to venous insufficiency and leg oedema.
  • ✓The primary symptoms of varicose veins and leg oedema in pregnancy include substantial pain, night cramps, numbness, tingling, and feelings of heaviness and achiness in the legs.
  • ✓Treatments for varicose veins and leg oedema in pregnancy are typically divided into surgical, pharmacological, and non-pharmacological approaches, with leg oedema treatment focusing primarily on symptom reduction rather than cure.

What This Means for You

If you're pregnant with varicose veins or leg swelling, some medications may help reduce symptoms, but evidence is limited and you should discuss options with your healthcare provider rather than relying on unproven treatments.

What This Means for Practitioners

While this systematic review does not evaluate reflexology, it demonstrates that pregnancy-related varicose veins and edema require evidence-based interventions, suggesting reflexologists should refer clients to appropriate medical care and work as part of a collaborative team.

Study Design: how this systematic review was run

Sample Size
326 participants
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Pregnancy: common questions

What does this study say about pregnancy?

If you're pregnant with varicose veins or leg swelling, some medications may help reduce symptoms, but evidence is limited and you should discuss options with your healthcare provider rather than relying on unproven treatments.

What did this study find?

Pregnancy is a major contributory factor in the increased incidence of varicose veins in women, which can lead to venous insufficiency and leg oedema. The primary symptoms of varicose veins and leg oedema in pregnancy include substantial pain, night cramps, numbness, tingling, and feelings of heaviness and achiness in the legs. Treatments for varicose veins and leg oedema in pregnancy are typically divided into surgical, pharmacological, and non-pharmacological approaches, with leg oedema treatment focusing primarily on symptom reduction rather than cure.

How strong is this evidence?

This is a systematic review and we rate its evidence moderate. It covers 326 participants. It was published in The Cochrane database of systematic reviews, a Q1 journal. This study is indexed here for context; it did not test reflexology itself.

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