Patient: 8 months pregnant and unable to get medical attention for pregnancy or anything else due to no insurance. No one is aware of pregnancy as well due to already being a single mom after being nearly killed by my ex husband. Over the past few months I began feeling a lot of pressure and a bulge in the vaginal area (left side). It’s becoming more painful and it’s not easy working as a CNA and being on my feet constantly. To see what this looked like, I decided to take a picture and I’m terrified at the sight I saw!!! There are several “knot” looking things that the only way I can describe look like small blueish or silverish balls or knots. On top of those, there is one giant bulge. What should I do with no one having knowledge of my pregnancy?
Doctor: From your symptoms and what you’ve mentioned, the bulge and “bluish colored knots” could be caused due to varicose veins . Varicose veins are abnormally enlarged superficial veins usually seen in the thigh and leg. Varicose veins commonly occur on the legs and thighs but may also occur in the vulva or vagina. Varicose veins are generally more prominent in the legs but during late pregnancy, they may develop near the vulva or vagina. The major reason is that the female retains a lot of weight and fluid during pregnancy. In addition, the baby in utero may also compress some parts of the pelvis (lower abdomen) and lead to an engorgement of the veins in the vulva/vagina. There is no treatment required for vulvar/vaginal varicosities. Once the baby is delivered, the varicosities will subside. In rare instances, there may be a rope-like vein but this will soon disappear with time. Unfortunately there is no cure for varicose veins but one can undertake preventive measures. These include :Elevation of the legs at all times is recommended.Lie on the left side with the legs elevated on a pillow. This prevents the fetus from pressing on the leg veins and decreases the chance of developing varicosities.Avoid standing for prolonged periods.Don’t cross your legs when sitting down.Wear elastic support stockings.When lying down, keep the legs elevated.Avoid tight clothing that can compress the waist or groin.