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 to 21 mmHg) on the left leg and class II stockings (25 to 32 mmHg) 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 versus 4/15 controls (p = 0.047); in addition, more treated women reported improved leg symptoms (7/27 versus 0/15 controls; p = 0.045). Emergent varicose changes, however, did not differ significantly (7/14 controls versus 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.

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