A 42-year-old primigravida presents to your office for a routine OB visit at 34 weeks gestational age. She voices concern because she has noticed an increasing number of spidery veins appearing on her abdomen. She is upset with the unsightly appearance of these veins and wants to know what you recommend to get rid of them. How do you advise this patient?
Vascular spiders, or angiomas, are common findings during pregnancy. They form as a result of the hyperestrogenemia associated with normal pregnancies and are of no clinical significance. The presence of these angiomas does not require any additional workup or treatment, and they will resolve spontaneously after delivery Reassurance to the patient is all that is required.
Tell her that this is not a serious condition and give her a referral to a vascular surgeon to have the veins removed
Tell her that you are concerned that she may have serious liver disease and order liver function tests
Refer her to a dermatologist for further workup and evaluation
Tell her that the appearance of these blood vessels is a normal occurrence with pregnancy and will resolve spontaneously after delivery
Physiological changes during Pregnancy