Q: I am a 28 years old girl and my calf muscles have been so tense and sore that I have been in constant pain for the last week. I am not sure if I have varicose veins but it runs in my family. My veins look like they are bulging in both my legs. I am in my third trimester of my sixth pregnancy and have never had this problem. What could be the problem with me? How can I ease the pain?

A:There is always some degree of increase in the venous pressure in the leg veins in pregnancy, particularly in the later part of the pregnancy. This is due to the pressure of the gravid uterus over the iliac veins. This almost always recedes when the delivery takes place. Occasionally there is some residual incompetence left over in the leg veins, which can manifest in the form of varicose veins. These are seen more commonly in people with family history of the varicose veins. I am slightly concerned that this acute pain in the calf and swelling in the legs and prominent veins may reflect the presence or onset of DVT either in the Vena Cava or Iliac veins. The pregnancy too can increase the risk of the onset of DVT. My suggestion would be to get an urgent Duplex scan of the lower limb veins done and, if this is confirmed, then treatment may need to be started soon. If the Duplex excludes the presence of DVT then a simple use of compression hosiery with some pain relief may be sufficient. The compression hosiery should be continued for some weeks after the delivery.