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Варикоз вен половых губ при беременности

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17 августа 2019

В период вынашивания ребенка в женском организме могут возникать различные патологии. Самая распространенная из них — варикоз половых губ при беременности.

Развивается он чаще всего при наличии этого же заболевания на нижних конечностях. Вены, расположенные на половых губах, увеличиваются в размерах, а их внутренние стенки подвергаются деформации.

Причины варикоза

Маленькие узелки на венах могут появляться во II триместре беременности, они не вызывают дискомфорт. Как они выглядят можно посмотреть на фото на медицинских порталах.

По мере развития плоды, давление на наружные половые органы увеличивают, кровоток усиливается, и образования начинают расти.

Кроме этого, варикоз половых губ во время беременности развивается по причинам:

  1. Изменение гормонального фона. После зачатия ребенка в организме женщины начинается усиленное продуцирование прогестерона. Под влиянием этого гормона происходит снижение эластичности стенок сосудов.
  2. Увеличение объема крови. Развивающемуся плоду необходимо большое количество кислорода и питательных веществ, поступающих через общий с матерью кровоток. Поэтому в организме объем крови увеличивается с 4000 мл до 5500 мл. За счет чего вены переполняются жидкой подвижной соединительной тканью, их стенки растягиваются и тонуса.
  3. Малоподвижный образ жизни. Беременным женщинам трудно проводить дни в активных движениях. Чаще всего время они проводят в положении сидя. Из-за этого в органах малого таза начинаются застойные явления, приводящие к снижению кровообращения.
  4. Избыточный вес. Набор веса при вынашивании ребенка происходит стремительно. Если не следить за калорийностью пищи, то высока вероятность развития ожирения. А избыточный вес является основной причиной варикоза на ногах, который с большой вероятностью охватит и половые губы.
  5. Частые запоры. При беременности женщины повсеместно страдают от нарушения акта дефекации. Скопление каловых масс давит на сосуды малого таза – появляется расширение вен половых губ.

Вероятность развития патологии увеличивается при вынашивании 2-х и более плодов и тяжелом родоразрешении предыдущей беременности. Женщины, беременные не в первый раз, сталкиваются с проблемой чаще тех, кто впервые ожидает ребенка.

Симптомы заболевания

Варикоз половых губ беременных проявляется постоянной болью. Она может распространяться на влагалище и иметь тянущий и ноющий характер. После длительного нахождения в одной позе и физических нагрузках болевые ощущения передаются нижним конечностям.

К симптомам патологии также относятся:

  • сосудистые звездочки и узелки;
  • уплотнение и опухание половых губ ;
  • изменение цвета эпидермиса;
  • зуд и жжение в промежности.

В положении сидя женщина чувствует давление и онемение в паховой области. Варикоз половых органов становится причиной отказа от сексуального жизни с мужем.

Методы лечения

После определения состояния кровотока при помощи УЗИ и дуплексного сканирования лечащий врач назначает медикаментозную терапию. Она заключается в нанесении на половые губы мазей и гелей с действующими веществами – витамин РР, гепарин, троксерутин.

При необходимости применяются препараты с этими же веществами в виде таблеток. Беременным женщинам также выписывают Гепариновую мазь, Гель Лиотон, и Троксевазин. В качествен дополнительной терапии назначается курс витаминных комплексов, в его составе обязательно должны быть витамины С и Е. Эти вещества помогают укрепить стенки сосудов и сделать их более эластичными.

В крайних случаях, когда необходимость срочного лечения перекрывает риск токсического действия на плод, используются препараты:

  1. Эндотелон. Капилляростабилизирующее средство понижает проницаемость сосудов. Схема приема – 2 раза в сутки по 1 таблетке. Курс лечения – 20 дней.
  2. Диовенор – ангиопротектор и корректор микроциркуляции. Уменьшает венозный застой, повышает тонус стенок. Принимать внутрь по 600мг натощак.
  3. Эскузан – капиляростабилизирующее средство с противоотечным и противовоспалительным действием. В небольшом количестве жидкости растворить 12-15 капель. Принимать 3 раза в сутки перед едой.
  4. Фраксипарин – антитромботический препарат гепариновой группы. Назначается в виде инъекций в амбулаторных условиях.

Антиварикозные лекарственные препараты назначает лечащий врач. Он же и определяет схему лечения и следит за реакцией организма женщины на действующие вещества. Самостоятельное применение этих средств может привести к нарушению развития плода.

При варикозе женщинам необходимо выполнять рекомендации:

  • не поднимать вес более 3 кг;
  • оптимально сочетать отдых и физическую нагрузку;
  • не допускать чрезмерный набор веса;
  • отказаться от принятия ванны – использовать только душ;
  • носить компрессионное нижнее белье;
  • следить за личной гигиеной;
  • спать на боку, между ног мягкий валик или подушка;
  • во время прогулок надевать бандаж на живот;
  • не употреблять продукты, способствующие застою жидкости в организме;
  • отказаться от обуви с высоким каблуком.

Эти советы также подходят для беременных женщин, которые хотят исключить развитие данной патологии. Такая профилактическая компания позволит выносить и родить ребенка без осложнений в паховой области.

Способы родоразрешения

Беременные женщины интересуются у личного гинеколога, как сочетается варикоз промежности и роды. Ответить на этот вопрос он может только после полного обследования и определения тяжести заболевания. В некоторых случаях заболевание не является прямым противопоказаниям для самостоятельных родов. После рождения ребенка есть вероятность угасания симптомом варикоза и полного излечения.

В запущенных и тяжелых случаях патология угрожает открытию сильного кровотечения при потугах из-за разрыва поврежденных сосудов. Естественные роды при варикозе могут привести к серьезному осложнению в виде развития острого варикотромбофлебита. Воспалительное заболевание затрагивает вены, расположенные на поверхности эпидермиса.

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В них образуются сгустки крови, провоцирующих появлению покраснения и затвердения большой области вокруг локализации. При такой опасности может быть принято решение о кесаревом сечении. Оно позволит избежать возможных трудностей при родоразрешении и исключить развития осложнений.

Врачи предупреждают! Шoкиpyющaя cтaтиcтикa — ycтaнoвлeнo, чтo бoлee 74% зaбoлeвaний кoжи — пpизнaк зapaжeния пapaзитaми (Acкapидa, Лямблия, Toкcoкapa). Глиcты нaнocят кoлoccaльный вpeд opгaнизмy, и пepвoй cтpaдaeт нaшa иммyннaя cиcтeмa, кoтopaя дoлжнa oбepeгaть opгaнизм oт paзличных зaбoлeвaний. Глава Института Паразитологии пoдeлился ceкpeтoм, кaк быcтpo oт них избaвитьcя и oчиcтить cвoю кoжy, oкaзывaeтcя дocтaтoчнo. Читать далее .

Будущие мамы, столкнувшись с симптомами пахового варикоза, не должны нервничать и пытаться избавиться от патологии народными средствами. Лучшим решением станет внеплановый визит к гинекологу и проведение диагностических исследований. По их результата уже будет видно, возможно ли вылечить патологию до родов или придется соглашаться на кесарево сечение.

Особенности заболевания

Естественная сопротивляемость организма заболеваниям у беременных женщин гораздо хуже, чем у остальных. Именно по этой причине можно проследить тенденцию к обострению хронических патологий и возникновению новых в период вынашивания ребенка. Варикозное расширение вен наружных половых губ чаще всего возникает в третьем триместре, когда ребенок оказывает наиболее сильное давление на организм матери, но болезнь может появиться и раньше.

Варикоз представляет собой патологию, при которой вены становятся ослабленными, утрачивают эластичность, начинают расширяться и извиваться. В запущенных случаях на этом фоне может возникать тромбофлебит – воспаление сосудистой стенки с последующим образованием тромба. Заболевание влияет не только на внешний вид пациентки, оно может угрожать ее здоровью и правильному развитию ребенка.

Нередко варикоз на половых губах развивается на фоне аналогичной патологии ног, поэтому возникновение заболевания можно предвидеть заранее. Это особенно важно в тех случаях, когда болезнь развивается бессимптомно. Зачастую при поддерживающей терапии она проходит скоро после родов, но в некоторых случаях может и развиваться дальше, особенно если лечение подобрано неправильно или совсем отсутствует.

Причины возникновения

Варикоз при беременности возникает достаточно часто, но происходит это не в каждом случае. Даже при изначальной предрасположенности пациентки к сосудистым заболеваниям основную роль играют предрасполагающие факторы. К возможным причинам варикозного расширения вен половых губ относят:

  1. Гормональные изменения. Во время беременности в организме женщины происходит значительная перестройка гормонального фона, в результате чего вены могут стать слабыми и уязвимыми. В большей степени на это влияет изменение уровня прогестерона и эстрогена.
  2. Рост плода. В связи с внутриутробным ростом ребенка матка также увеличивается в размерах и постепенно оказывает все большее давление на кровеносную сеть в области органов малого таза. В результате этого кровообращение замедляется, что приводит к образованию застоев, расширяющих просвет сосудов.
  3. Увеличение объема циркулирующей крови. Организму беременной женщины приходится снабжать питательными веществами и кислородом не только собственные ткани, но и клетки ребенка. По этой причине увеличивается количество циркулирующей в сети крови, которая расширяет ослабленные вены.
  4. Хронические заболевания половых органов. Обострение имеющихся патологий мочеполовой системы негативно сказывается на кровообращении в этой области.
  5. Статичный образ жизни. Беременным женщинам нужно двигаться в меру возможностей, обычные пешие прогулки обязательны, а остальные виды физической активности нужно согласовывать с врачом. Малая двигательная активность в период вынашивания ребенка способствует множественным проблемам со здоровьем.
  6. Нерациональные нагрузки. Излишние нагрузки, как и недостаточные, идут во вред. Кроме того, длительное пребывание на работе в стоячем или сидячем положении увеличивает риск развития варикоза в паховой области.
  7. Увеличение массы тела. В период беременности женщина может стремительно набирать вес, а это, в свою очередь, увеличивает нагрузки на организм, в частности, кровеносные сосуды нижних конечностей. Варикоз ног постепенно приводит к поражению половых губ.
  8. Врожденные патологии. Если у пациентки наблюдаются генетические аномалии в строение кровеносной системы или конкретно венозных клапанов, в период беременности риск развития заболеваний на этой почве повышается.
  9. Запоры. Нарушения стула часто возникают при беременности, это провоцирует повышение давления в кровеносных сосудах органов малого таза.

Таким образом, в группе риска находятся многие беременные женщины. На развитие заболевания могут также повлиять вредные привычки, особенно если от них не отказались в период вынашивания ребенка.

Плохая экология и нездоровый образ жизни в целом также могут сыграть свою роль. Наиболее предрасположены к варикозу половых губ женщины, переживающие тяжелые роды, а также уже рожавшие с осложнениями.

Симптомы патологии

Как правило, симптомы болезни пациентка замечает самостоятельно, поскольку они проявляются как в ощущениях, так и в видимых изменениях. В некоторых случаях патология протекает без явных признаков, и ее удается распознать только при профилактическом обследовании.

Варикоз половых губ во время беременности проявляется следующим образом:

  • набухание поверхностных вен;
  • увеличение самих половых губ в размерах;
  • в области поражения кожа становится сухой и изменяет оттенок;
  • появляется зуд и жжение;
  • проявляется сосудистый рисунок в виде звездочек или сеточки;
  • возникает боль, усиливающаяся при половом контакте;
  • возникает чувство распирания и тяжести;
  • может быть нарушен привычный процесс мочеиспускания.
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Также пациентка может ощущать изменения при пальпации пораженной области. Однако несмотря на простоту самодиагностики, необходимо сразу после появления одного или нескольких симптомов обратиться к гинекологу. Он не занимается лечением вен, но может провести первичное обследование, чтобы выявить, что проблема связана именно с варикозом. В этом случае он дает направление на консультацию флеболога.

Для уточнения диагноза используются как лабораторные анализы крови, так и инструментальные методы диагностики.

Наиболее информативным является дуплексное сканирование, то есть ультразвуковое исследование с применением датчика Допплера. Дополнительно могут назначаться другие неинвазивные процедуры из области флебологии.

Лечение патологии

В большинстве случаев варикоз половых губ диагностируется на ранних стадиях развития, поэтому с болезнью можно справиться консервативными методами. Операции назначаются только в самых крайних случаях, когда болезнь развивается стремительно, и существует опасность для жизни пациентки или ребенка.

В качестве медикаментозных средств врач может назначать деликатные лекарства, которые допустимо использовать беременным женщинам. К таким препаратам относятся флеботоники, улучшающие тонус вен, ангиопротекторы, укрепляющие и защищающие сосуды, а также различные симптоматические лекарства и витаминно-минеральные комплексы.

Среди лекарств от варикоза, часто назначаемых женщинам во время беременности можно отметить:

  1. Троксерутин (таблетки, капсулы и гель). Средство нельзя применять лишь на ранних сроках беременности, а во втором и третьем триместре, а также в период лактации использование допустимо. Среди противопоказаний отмечается индивидуальная непереносимость компонентов препарата, язва и хронический гастрит.
  2. Диосмин (таблетки). Препарат можно применять на любом сроке беременности, но во время лактации от его использования лучше отказаться. Среди противопоказаний выделяют аллергию на препарат и возраст менее 18 лет.
  3. Детралекс (таблетки). Можно применять в любом триместре беременности, но не рекомендуется использовать в период грудного вскармливания. Противопоказанием является лишь аллергия на средство.
  4. Флебодиа (таблетки). Назначаются для лечения варикоза во втором и третьем триместре беременности, на ранних сроках и в период лактации прием противопоказан. Также ограничением является аллергия и возраст менее 18 лет.
  5. Лиотон (гель). Можно применять на любом этапе беременности, а также в период грудного вскармливания, но только под наблюдением врача. Среди противопоказаний аллергия, открытые раны и язвы на коже, пониженная свертываемость крови, тромбоцитопения.

Помимо этого, можно использовать средства для наружного применения (мази, гели, кремы), в составе которых присутствует экстракт конского каштана либо гинкго-билоба, если в противопоказаниях не указана беременность.

Прием любого препарата нужно обсуждать с лечащим врачом, чтобы исключить риск осложнений для себя и ребенка.

В качестве операций применяются не традиционные открытые хирургические вмешательства, а малоинвазивные современные процедуры. Чаще всего применяется склеротерапия, в ходе которой в пораженную варикозом вену вводят специальное вещество (склерозант), склеивающее ее и предотвращающее дальнейшее развитие болезни.

При согласовании с врачом можно делать гимнастику для беременных.

Как рожать при варикозе половых губ

Роды при варикозе половых губ проходят естественным образом, поскольку заболевание не является противопоказанием к этому. Лишь в некоторых случаях при стремительном развитии заболевания и угрозе серьезных осложнений лечащим врачом может быть назначено кесарево сечение.

В любом случае ближе к предварительной дате родов пациентке назначается обследование, в ходе которого выясняется возможность естественно процесса. Если заболевание было диагностировано на ранних стадиях развитиях, его зачастую удается вылечить заблаговременно, и роды не осложняются дополнительными процедурами.

Профилактические меры

Беременная женщина подвергается многим опасностям со стороны заболеваний, поэтому рекомендуется заранее заботиться о своем состоянии и здоровье ребенка. Для профилактики варикозного расширения вен в паховой области не потребуется выполнять сложных действий, нужно лишь немного скорректировать свой образ жизни.

В первую очередь следует отказаться от ношения тесной синтетической одежды и обуви на высоком каблуке. Также следует отдавать предпочтение активным видам отдыха, желательно на свежем воздухе. Если работа сопряжена с тяжелыми физическими нагрузками, рекомендуется уйти в декретный отпуск раньше. Кроме этого, нужно скорректировать свой рацион, отказавшись от жирной жареной пищи, копченостей, маринадов, острых и соленых продуктов. Нелишним будет ежедневный прием контрастного душа.

Отдельно следует сказать о ношении компрессионного белья. Тем женщинам, которые склонны к сосудистым заболеванием, в течение всей беременности рекомендуется носить утягивающий трикотаж профилактического назначения. Это могут быть как компрессионные колготы, так и специализированные бандажи для беременных. Определиться с размером и конкретной моделью белья поможет лечащий врач.

Варикоз половых губ при беременности – распространенная патология, которой страдают около 20% от общего числа всех женщин, ожидающих малыша.

Болезнь доставляет физиологический и психологический дискомфорт, поскольку на поздних сроках состояние половых органов усугубляется, женщина чувствует сильные боли, а сама промежность имеет не эстетический внешний вид. Добавляются страхи и тревожность за протекание беременности и роды.

Симптомы заболевания

При беременности женщины набирают лишний вес, нагрузка на нижние конечности и промежность усиливается, поскольку увеличивается объем циркулирующей крови. Стенки сосудов не справляются с нагрузками, они становятся менее упругими. В результате развивается варикоз.

Симптоматика заключается в следующем:

  • в промежности появляются некрасивые звездочки и узлы;
  • возникновение шишечек синеватого цвета;
  • расширение вен половых губ;
  • женщины испытывают сильные боли при мочеиспускании, сексе и ходьбе;
  • болезненные ощущения усиливаются на поздних сроках беременности;
  • на участках слизистой, которые поражены варикозом, кожа становится сухой и раздраженной, а вены набухают.
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Почему развивается варикоз половых губ

Во время беременности у женщин обостряются все хронические заболевания, поскольку организм ослабевает. Это вызвано тем, что иммунная система в нормальном (неподавленном) состоянии вытолкнет плод из организма.

Варикоз половых губ во время беременности развивается по следующим причинам:

  • у женщины увеличивается масса тела, а это создает нагрузку на вены. Подкожные сосуды не окружены мышцами, в отличие от глубоких вен. Поэтому они страдают из-за нагрузки в первую очередь;
  • увеличивается объем циркулирующей крови, что негативно влияет на вены. Стенки вен менее эластичны, чем стенки артерий;
  • по мере развития плода у женщин растет матка, она задерживает отток крови в венах органов малого таза;
  • в организме вырабатывается прогестерон, уже на первых сроках беременности увеличивается количество гормона. Избыток прогестерона влияет на состояние коллагеновых волокон.

На варикоз половых губ влияет наследственная предрасположенность, неправильное питание, особенности работы (при долгом пребывании в стоячем положении).



Диагностика

При появлении первых признаков требуется пойти на прием к гинекологу. Он проведет осмотр, исследует влагалище и слизистую при помощи специального зеркальца.

Для подтверждения анализа доктор назначает УЗИ органов малого таза, которое позволит оценить состояние системы вен. При необходимости необходим осмотр у врача-флеболога. Также будущим мамам предстоит сдать общий анализ крови для выяснения протромбинового индекса и сделать доплерографию.

Как лечат болезнь

Варикоз половых органов требует лечения. Оно проводится двумя способами: консервативным и медикаментозным. На начальных стадиях врачи прибегают к первому методу. При соблюдении всех рекомендаций состояние беременных остается нормальным в течение всех трех триместров.

К правилам относятся следующие:

  • беременным запрещается носить любую обувь на каблуках;
  • нельзя поднимать тяжести, необходимо избегать высоких физических нагрузок;
  • рекомендуется принимать теплый душ и отказаться до родов от горячих ванн;
  • будущим мамам нужно носить специальное белье, рекомендованное при варикозе. На нем нет швов и плотных резинок, что провоцирует ухудшение кровотока крови;
  • женщинам стоит ежедневно совершать пешие спокойные прогулки на свежем воздухе и пару раз в неделю плавать в бассейне;
  • врачи рекомендуют выполнять гимнастику, улучшающую состояние вен. Комплекс подбирается врачом индивидуально, исходя из состояния пациентки.

Выполнение рекомендаций поможет улучшить состояние женщины, способствует нормальному протеканию беременности. Полностью вылечиться от варикоза половых губ можно только после родов.

Компрессионное белье носят по строгим правилам: его не снимают в течение всего дня, надевают с утра, прежде чем встать с кровати и стирают ежедневно.

Медикаментозное лечение

1000 мг.

В более запущенных стадиях болезни врачи прибегают к другим способам терапии. Они заключены в приеме венотонозирующих препаратов. Чаще всего назначают «Флебодию» и «Детралекс». Также возможно использование гелей и кремов для местного применения. Их втирают в пораженные места.

Если варикоз половых губ беременных продолжает прогрессировать, несмотря на все меры предосторожности, то флебологи прибегают к микропенной склеротерапии. Это эффективный и безболезненный метод. Он безопасен для будущих мам.

В пораженные и отекшие участки слизистой оболочки вводят лекарственный препарат, который похож на пену. Средство суживает больной сосуд, пускает кровь по здоровым сосудам. После чего пораженный участок паховой области на несколько минут сдавливают. Данный метод помогает улучшить состояние при варикозе.

Если патология не прошла после родов, то хирурги прибегают к оперативным методам лечения варикоза половых губ: флебэктомии (выдергивание тромба при помощи зонда), радиочастотной коагуляции (разрушение больных вен) или лазерной коагуляции (лечение больных вен при помощи лазерного луча).

Женщин с расширением вен всегда интересует вопрос: как протекают роды при варикозе? Если у беременных заболевание на начальной степени, то это состояние не является противопоказанием к рождению малыша естественным путем.

Умелый и опытный акушер-гинеколог предотвратит любые осложнения. Единственная вероятная опасность – разрыв вены и кровотечение. В этом случае врач зашивает вену и кровоток нормализуется.

На 38-39 неделе беременных могут положить в роддом, на дородовую госпитализацию. Это позволит контролировать состояние будущих мамам. Если варикоз половых губ прогрессирует, то женщинам показано кесарево сечение.

Варикоз промежности и роды – два естественных фактора, с которыми сталкиваются акушеры-гинекологи. Главное – доверять доктору и выполнять все его рекомендации.

Заключение

Беременность – одно из самых значительных событий в жизни женщин. Но у будущих мам зачастую обостряются хронические болезни, ухудшается общее самочувствие. У каждой пятой беременной проявляется варикоз половых губ. На промежности появляются звездочки и шишечки, она отекает.

Врачи предупреждают! Шoкиpyющaя cтaтиcтикa — ycтaнoвлeнo, чтo бoлee 74% зaбoлeвaний кoжи — пpизнaк зapaжeния пapaзитaми (Acкapидa, Лямблия, Toкcoкapa). Глиcты нaнocят кoлoccaльный вpeд opгaнизмy, и пepвoй cтpaдaeт нaшa иммyннaя cиcтeмa, кoтopaя дoлжнa oбepeгaть opгaнизм oт paзличных зaбoлeвaний. Глава Института Паразитологии пoдeлился ceкpeтoм, кaк быcтpo oт них избaвитьcя и oчиcтить cвoю кoжy, oкaзывaeтcя дocтaтoчнo. Читать далее .

К тому же будущие мамы испытывают сильные боли. Обычно болезнь проходит после родов. На начальных стадиях рекомендуется консервативное лечение, при прогрессировании болезни врачи прибегают к медикаментозным методам терапии.

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