Compression stockings prophylaxis of emergent varicose veins in pregnancy: a prospective randomised controlled study.

QUESTIONS UNDER STUDY To determine the efficacy of compression stockings in preventing emergent varicose veins in pregnancy. METHODS A prospective randomised controlled study in the outpatient department of the University Hospital of Zurich, Switzerland, including women with uncomplicated pregnancies <12 weeks at outset of study. A no-stockings control group (n = 15) was compared with two treatment groups: group 1 (n = 12) wore compression class I stockings (18-21 mm Hg) on the left leg and class II stockings (25-32 mm Hg) on the right; in group 2 (n = 15), the compression classes were reversed. Stockings were worn from study entry to term. Endpoints were emergence and worsening of superficial varicose veins, long saphenous vein reflux at the sapheno-femoral junction, and leg symptoms (pain, discomfort, cramps) during pregnancy. RESULTS Both classes of compression stockings failed to prevent the emergence of superficial varicose veins. However, long saphenous vein reflux at the sapheno-femoral junction was observed in the third trimester in only 1/27 treated women vs. 4/15 controls (p = 0.047); in addition, more treated women reported improved leg symptoms (7/27 vs. 0/15 controls; p = 0.045). Emergent varicose changes, however, did not differ significantly (7/14 controls vs. 5/12 in group 1 and 8/14 in group 2; 3x3 table, Fisher's exact = 0.94). CONCLUSIONS Although compression stockings do not prevent the emergence of gestational varicose veins, they significantly decrease the incidence of long saphenous vein reflux at the sapheno-femoral junction and improve leg symptoms. Our results also suggest that superficial varices and deep venous insufficiency may have a different aetiology.