Q: I am a 36 years old female. I am expecting my second baby in 10 days. I have developed varicose veins. My doctor told me that varicose veins might not vanish even after delivery and I have to undergo a surgery. Can physiotherapy or external exercises treat varicose veins?

A:The varicose veins are not uncommon following pregnancy and are made worse by every successive pregnancy. It is not advisable to get any definitive treatment done during the pregnancy. The treatment should wait till at least six months after delivery, when all the physical and hormonal changes related to pregnancy have reversed. Also if the patient wants to have more children then it is better to complete the family before seeking any definitive treatment/surgery. It is also important that precautions are taken during pregnancy and at the time of delivery; these are - to prevent deep vein thrombosis. Patient should preferably wear compression stockings till the time she is ready for investigation and surgery. If there is history of deep vein thrombosis then low molecular weight heparin is also indicated at the time of delivery and for few days after the delivery. There is no particular physiotherapy or exercises needed, except regular walking, with stockings on.