What is the cause of edema in pregnancy

Many women experience swollen feet during pregnancy. Swelling is common at this time because the body retains extra fluid to protect and support the growing fetus.

Swelling in the feet usually happens later in pregnancy, when the weight of the uterus and fetus puts extra pressure on the legs and feet. This pressure can reduce circulation and increase fluid buildup, which causes swelling.

Here, we look at the steps that women can take at home to reduce swelling. We also discuss the signs that may indicate more serious conditions and explain when to see a doctor.

Swelling in certain parts of the body is a normal part of pregnancy. It often occurs because the body generates extra fluid to help support the growth of the fetus. Also, circulation slows down, which can add to the buildup of fluid.

The feet and ankles can swell because the uterus expands with the growing fetus, putting more pressure on the veins in the lower body.

Swelling in the feet is most common in the later stages of pregnancy, or the third trimester. The reason for this is that the fetus is larger and puts more pressure on the legs and feet.

In women who experience swollen feet during pregnancy, the swelling typically:

  • appears gradually
  • is worse in hot weather
  • appears worse by the end of the day
  • lessens when they lie down or raise the feet
  • is equal in both feet

Women may be able to reduce swelling in the feet during pregnancy by taking the following steps at home:

  • avoiding standing for long periods, as this can increase pressure in the legs and feet and cause more swelling
  • elevating the feet slightly to increase blood flow toward the heart
  • raising the legs on pillows while sleeping
  • wearing supportive tights or compression stockings to help improve circulation in the legs
  • keeping active throughout the day, with short walks or gentle exercise
  • limiting salt intake
  • staying hydrated and drinking 8–10 glasses of fluid each day to help prevent the body from holding onto excess water
  • avoiding caffeine, as it is a diuretic, which means that it promotes the increased production of urine
  • wearing loose, comfortable clothing
  • wearing loose socks and comfortable shoes
  • avoiding sitting for long periods
  • staying cool and spending limited time outdoors in hot weather
  • sleeping on the left side of the body, which can help increase blood flow to the heart
  • trying massage or reflexology to improve circulation

Exercises

Doing foot exercises when resting can help improve circulation.

Pregnant women can try raising one foot off the floor and flexing it up and down 30 times before repeating the movement with the opposite foot.

Next, they can raise one foot off the floor and rotate it clockwise eight times and then anticlockwise eight times. Again, they should then repeat this with the opposite foot.

Although they may be uncomfortable, swollen feet are a common effect of pregnancy. Medical treatment is unlikely to be necessary, and many women can relieve the swelling with home remedies.

However, a woman will require medical treatment if an underlying condition is causing the swollen feet.

Swelling can sometimes signal a health issue in pregnancy. Women should contact their midwife, doctor, or healthcare team immediately if they notice any sudden or rapid increase in swelling.

Preeclampsia

A sudden increase in swelling in the feet can be a sign of preeclampsia. Women may also notice a puffy or swollen face, swelling around the eyes, or sudden swelling in the hands.

If the swelling in the feet is extreme, pressing down into the skin may leave an indentation for a few seconds. There might also be some decolorization in the legs.

Preeclampsia is a health condition that can happen during pregnancy or postpartum. Preeclampsia causes very high blood pressure and organ problems in pregnant women.

It most commonly occurs after 20 weeks of gestation or up to 6 weeks after giving birth. Preeclampsia can progress quickly, and without treatment, it can be very dangerous for the woman and the fetus.

A doctor may prescribe antihypertensive drugs to lower blood pressure. If the pregnancy has reached 37 weeks or more, healthcare professionals may recommend delivering the baby early.

Deep vein thrombosis

Uneven swelling in the feet or legs may indicate a blood clot, known as deep vein thrombosis (DVT).

Pregnant women and women who have given birth within the last 3 months have a higher risk of DVT than women who are not pregnant. The reason is that blood clots more easily during pregnancy to prevent excess blood loss during labor and birth.

The growing fetus also puts pressure on the legs, which can reduce circulation. Being less mobile than usual during both pregnancy and the recovery period after delivery can also reduce blood flow in the legs.

A doctor may prescribe a drug called low-molecular-weight heparin to prevent or treat blood clots and DVT. They will inject the drug under the skin.

If women have any concerns about swollen feet during pregnancy or are not able to relieve uncomfortable symptoms, they can talk to their healthcare provider to discuss treatment options.

They should contact their doctor or midwife immediately if they notice any of the following symptoms:

  • a sudden increase in swelling in the feet
  • sudden swelling in the hands or face or around the eyes
  • a severe headache or a constant dull headache
  • blurred vision or seeing “stars” or flashing lights
  • severe pain below the ribs or in the abdomen, especially on the right side
  • nausea, vomiting, or feeling unwell
  • swelling is present at the beginning of the day and does not improve when lying down or raising the feet

The above symptoms can all be signs of preeclampsia, and pregnant women will require medical attention straight away to prevent the condition from progressing.

Women should also contact their doctor straight away if they notice that:

  • one foot or leg is more swollen than the other
  • there is pain or heat in the calf or elsewhere in the leg
  • the skin on the leg is red or discolored

Uneven swelling or pain in the leg could indicate DVT. Without treatment, DVT can lead to the blood clot traveling to the lungs and causing a pulmonary embolism. It is important to seek immediate medical attention for:

  • difficulty breathing
  • chest pain, which worsens when coughing or breathing deeply
  • coughing up blood
  • increased or irregular heartbeat

Swelling in the feet is usually a normal feature of the later stages of pregnancy and not a cause for concern. The body stores excess water during pregnancy. Also, pressure from the fetus can reduce circulation in the legs, which causes swelling in the feet.

Home remedies for swollen feet during pregnancy include elevating the feet when sitting down and wearing loose, comfortable shoes. Drinking plenty of water, engaging in regular gentle exercise, and avoiding standing for long periods may all help, as well.

If pregnant women notice a sudden increase in swelling in the feet, hands, or face, or around the eyes, they should contact a doctor straight away.

Sudden swelling can be a sign of preeclampsia, a condition that will require medical treatment. Pregnant women should also contact their doctor straight away if they have uneven swelling, pain, redness, or warmth in one leg, as these symptoms could indicate DVT.

Most women get swollen ankles and feet while pregnant. It’s natural to have concerns about swelling since it can be uncomfortable, make your shoes tighter and possibly make you feel embarrassed. Knowing what to look for and how best to manage it can help you stay as comfortable as possible.

There are 3 main reasons women experience swelling while pregnant.

  • Throughout pregnancy, you produce more blood than usual to help your baby grow.
  • As the baby grows, your uterus presses on and slightly blocks the veins that return blood from your legs to your heart.
  • Your hormones make the walls of your veins softer, which makes it harder for them to work properly.

For these reasons, your blood tends to pool in your legs. There, a small amount of blood leaks through tiny blood vessels into the tissues and produces the swelling you can see and feel.

Where and when will I get swelling?

The swelling should be only in your feet and ankles. Your fingers might get a little larger — enough to make any rings feel tight — but they shouldn't be obviously swollen.

Your feet and ankles are likely to swell later in the day. This is mainly due to gravity — any extra fluid in your body will sink to your feet and ankles, especially if you spend a lot of time on your feet.

Swelling is also more likely to happen later in your pregnancy.

Gradual swelling isn't harmful to you or your baby, but it can feel uncomfortable.

How can I reduce swelling?

Some simple things can help you feel more comfortable and can also aid in preventing swelling.

Try to:

  • avoid standing for long periods without moving
  • wear comfortable shoes (avoid tight straps or anything that might pinch if your feet swell)
  • put your feet up as much as you can
  • limit salty foods and excessive salt in your diet
  • sleep on your left side, which will help blood return to the heart
  • exercise regularly by walking or swimming — this helps keep your circulation going

If you need to stand for long periods, try to move around and change position regularly.

Compression stockings can help the blood flow back to the heart and limit how much swelling you get. Massage and reflexology might also help reduce swelling and associated symptoms.

Even if your swelling is bothering you, remember to still drink plenty of water. Keeping your fluids up is important to avoid dehydration and stay healthy.

Normal or abnormal swelling?

Most pregnant women have swollen feet and ankles at some point, and this is perfectly normal. However, there are times when swelling could indicate something more serious.

Contact your midwife, doctor or hospital immediately if:

  • swelling is there at the start of the day or doesn't go down when you rest
  • your face or hands are swollen
  • the swelling is more than you have had before

These are warning signs for pre-eclampsia, which is high blood pressure caused by pregnancy. This is a very serious condition both for you and your baby, so call your doctor or midwife as soon as possible. Don't wait for your next regular appointment.

If one leg is more swollen than the other, this could suggest a more serious problem with one of your veins, such as deep vein thrombosis. Again, contact your doctor or midwife as soon as possible.

Most swelling is a normal part of pregnancy and will usually go away after you've given birth. However, if you're concerned about anything, no matter how small or seemingly insignificant, talk to your doctor or midwife.

You can also call Pregnancy, Birth and Baby on 1800 882 436 to talk to a maternal child health nurse.

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