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5 ways to manage swollen legs and feet during pregnancy | Your Pregnancy Matters

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MedBlog

Your Pregnancy Matters

September 14, 2021

Your Pregnancy Matters

Robyn Horsager-Boehrer, M. D. Obstetrics and Gynecology

Of all the body parts you expect to get bigger during pregnancy, feet might not be at the top of your list. But most pregnant women experience swelling in their lower legs and feet.

If your ankles appear puffy and your shoes don’t feel quite right, you’re not imagining things. The additional fluid and blood your body creates to support healthy fetal growth also slows down blood circulation. That can cause blood to accumulate in your lower extremities, causing swelling.

During pregnancy, you also produce more relaxin, a hormone that helps your tendons, ligaments, joints, and muscles – you guessed it – relax. While relaxin helps your pelvis open to give birth, it also loosens the tendons and ligaments in your feet.

The combination of extra weight and hormones during pregnancy can cause your feet not only to widen but also flatten and lengthen. Leg or ankle swelling likely will decrease a week or two after your baby is born, but your feet may never be the same again.

Studies have shown that pregnancy can cause a permanent decrease in your arch and increase in foot length – typically only after a woman’s first pregnancy.

While more research is needed to determine whether these structural changes can be prevented, there are a few things you can do throughout your pregnancy to reduce swelling and feel more comfortable.

Coping with swollen legs and feet during pregnancy

1. Wear compression socks

Wearing 15-20mmHG compression socks that end at your knee can help alleviate achiness. The socks gradually increase pressure in your legs and move some of the excess fluid back into your blood vessels and the rest of your body.

Avoid socks with a tight band at the top. The tightness might worsen swelling by blocking blood return. That can increase your risk of developing a blood clot – which is already five times higher during pregnancy. You don’t need to purchase medical-grade socks, but you can find a good pair of compression socks for $10-$20.

Compression socks also can prevent the formation of new varicose veins, which occur in 15% of pregnant women for the same reason that causes swelling. The risk doubles after your first pregnancy and is four times higher in women over 35. These veins start out as little bumps under your skin; the socks squeeze them just enough to prevent backward blood flow and bulging. Existing varicose veins aren’t likely to shrink, but compression socks can reduce the pain and discomfort they cause.

2. Rest efficiently

You can easily improve blood circulation during downtime and sleep:

• Elevate your legs above heart level while reading, watching TV, or doing other seated activities. The simple change in body position decreases pressure on your veins, which no longer have to work against gravity to send blood to your heart. Use cushions for comfort and elevate in 15- to 20-minute intervals a few times a day.
• Sleep on your left side. While you can safely sleep on either side during pregnancy, the left side is often recommended to avoid putting pressure on the inferior vena cava, a large vein that carries blood from your lower extremities to your heart.

3. Get your feet wet

Immersing your feet and ankles in cool water for 20 minutes a few times a week can minimize swelling, whether you use a pool, bathtub, or even a large bowl. Bonus: It’s also a great way to deal with the Texas heat if you’re pregnant during the summer.

Be sure the water temperature is moderate and not ice cold. Cooler temperatures cause the smaller blood vessels close to your skin to constrict, which reduces blood flow to and swelling within the affected area. Water that is too cold can have the opposite effect. Whether you stand and sway or sit and dangle your feet, water therapy is a great way to relieve stress and pain.

Related reading: Water immersion during labor

4. Invest in supportive shoes that fit.

Unsupportive and uncomfortable shoes can cause even more leg and foot pain, plus backaches. Even if your feet return to their pre-pregnancy size, you’ll feel more comfortable in shoes that fit your feet and support your additional body weight. The American College of Obstetricians and Gynecologists recommends wearing shoes that:

• Have a low heel but are not flat
• Provide good arch support, such as athletic shoes

Many patients prefer shoes that have mesh, which allow their feet to breathe, and can easily slip on and off to limit bending over while pregnant. More shoe brands are merging comfort and style, so even the most fashionable patients will have no problem finding footwear they feel good about wearing.

5. Visit a podiatrist or pedicurist.

Another reason to wear shoes that fit: Stress from tight shoes can cause ingrown toenails, and so can infrequent nail trimming. In the first two trimesters you probably won’t have any difficulty trimming your toenails. But once you reach the third trimester, it might get more challenging.

Try propping up your feet on a stool or ask your partner to help trim your toenails. Nail salon gift cards are a great item to add to your baby shower (or sprinkle!) registry, too.

Seeing a podiatrist is another option to prevent or treat painful foot conditions, such as ingrown toenail, bunions, or plantar warts.

When swelling becomes serious

While gradual swelling in your lower and upper extremities is normal, sudden or severe swelling in your face, hands, or feet might be a symptom of preeclampsia. This pregnancy complication involves very high blood pressure.

If you have preeclampsia, you may need to stay in the hospital until you give birth. Delivery is the only way to “treat” preeclampsia. Left untreated, the condition can cause seizures, kidney or liver damage, and in rare cases, death.

Related reading: Postpartum hypertension: When a new mom's blood pressure is too high

Talk with your doctor about foot and leg swelling, as well as any other pregnancy symptoms. The more we know about your current condition, the more we can help reduce your risk of future complications.

While we can’t fully prevent foot and leg swelling, we can recommend ways to reduce your risk, such as:

• Regular exercise
• Good-quality sleep
• A healthy diet rich in fruits and vegetables

Discomfort during pregnancy is to be expected, but our goal is to partner with you to minimize it – as well as the risk of more serious conditions.

To discuss your pregnancy concerns or symptoms with an expert, call 214-645-8300 or request an appointment online.

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More Articles

How to remove edema during pregnancy and why they are dangerous

Edema during pregnancy appears in most women "in position". Most often, they notice swelling in the third trimester, after 30 weeks, however, with late toxicosis, symptoms of fluid retention appear as early as the 18th week.

General information

During the period of bearing a child in a woman's body, the volume of fluid increases significantly, at least twice. As a result, the internal organs experience increased stress, which leads to swelling.

Most often in pregnant women, the legs swell in the area of ​​\u200b\u200bthe feet and ankles, because under the influence of gravity, the water descends. But over time, swelling can spread to the hands, face, and sometimes the whole body.

Species

Given the prevalence, swelling during pregnancy is of 2 types:

1. Localized (local)

When only one part of the body swells - legs, arms or face.

2. Generalized (generalized)

In which edema spreads to the whole body.

Generalized edema is called dropsy of pregnancy and is a consequence of the release of plasma into the intercellular space. Puffiness is generally characteristic of late toxicosis, or gestosis, but it manifests itself with varying degrees of severity.

In some cases, gestosis is quite difficult and is accompanied by such conditions as:

• nephropathy

It develops against the background of dropsy in about a quarter of women. With nephropathy, blood pressure rises, dizziness, lower back pain, and digestive problems;

• pre-eclampsia

The next stage after nephropathy with the preservation of edema and the appearance of severe headache, weakness, nausea, turning into vomiting. Typical signs of preeclampsia are drowsiness, blurred vision, lethargy and trembling in the hands;

• eclampsia

Replaces preeclampsia and lasts no more than 3-4 days. The clinical picture includes severe edema and other symptoms of preeclampsia, against which a convulsive attack appears, turning into a coma. The coma can either get worse or end with the restoration of consciousness.

General edema in pregnant women causes a change in the composition of the blood, which, in turn, leads to fetal hypoxia. Edema can be both obvious and hidden: the first is visible to the naked eye, and the second is determined by too sharp weight gain.

Attention! If during pregnancy weight gain was more than 18 kg, then doctors ascertain internal edema. The volume of fluid consumed significantly exceeds the amount of urine excreted.

Causes of edema in pregnancy

Edema during gestation can be physiological and pathological. Fluid retention in both cases is due to hormonal fluctuations. Already from the first weeks of pregnancy, the level of progesterone begins to rise, which is necessary to reduce the contractile activity of the uterus and prevent miscarriage.

In the first trimester, the concentration of progesterone already increases 10 times! And the same hormone prevents the excretion of sodium and water from the body, as the need for fluid also increases.

Why pregnant women need more fluids:

1. The volume of circulating blood should be sufficient for the blood supply to the fetus.
2. The formation of the placenta and amniotic fluid is impossible with the same amount of fluid.

The growing uterus puts pressure on the vessels, thereby provoking stagnation of blood in the pelvic organs and lower extremities. Therefore, even a healthy woman may experience swelling of the legs.

The amount of fluid during pregnancy increases by 6-8 liters. From 4 to 6 of them fall on the placenta, the remaining 2-4 liters are distributed throughout the body.

The mechanism of development of physiological and pathological edema is associated with three factors, including:

• hormonal changes;
• sodium retention;
• poor outflow of blood from the pelvic organs and legs.

Symptoms

Edema is not always visible visually and is sometimes determined only by weighing. For some women, even 5 liters of excess fluid can be completely invisible, while for others, temporary water retention causes visible swelling in different parts of the body.

Typical symptoms of edema:

• traces on the skin from socks and seams of clothing that do not “straighten out” for a long time;
• heaviness in the legs, especially in the evening;
• if you press on the shin or foot, a notch remains;
• habitual shoes become tight;
• unable to clench the hand into a fist;
• it is difficult to put on or take off the ring from the finger;
• tingling and slight numbness in the fingers due to compression of the nerves by swollen tissues;
• puffiness of the face;
• increase in chin, lips, nose in volume.

Book an online consultation if you experience swelling during pregnancy. Our doctors remotely, by phone or video call, will help interpret the symptoms and talk about methods of dealing with edema. Experts on call around the clock, contact for advice at any time.

Which doctor to contact

First you need to go to the gynecologist who leads the pregnancy. He will prescribe an examination and tell you which doctor to book a consultation with. With high pressure and the presence of protein in the urine, preeclampsia can be assumed, which often requires hospitalization. Gynecologists deal with this problem.

If there is a predisposition to varicose veins, heaviness or pain is felt in the legs, then you need to visit a phlebologist.

Alarm symptoms:

• swelling appears in the morning;
• excess weight gain was recorded in the early stages, already in the 1st trimester;
• constant thirst and decrease in urination with the use of the usual volume of liquid;
• shortness of breath, a feeling of fullness and heaviness in the chest;
• persistent bags under the eyes;
• swelling rises above the knees.

Diagnostics

Sometimes it is not easy to distinguish physiological from pathological edema, so a woman is prescribed an examination. It may include different diagnostic methods:

According to indications, a woman may be prescribed an ultrasound of the pelvic organs, thyroid gland, kidneys, vessels of the lower extremities. In cardiac pathologies, a cardiogram is made, daily Holter monitoring, and phonocardiography are carried out.

How to get rid of edema

You can fight on your own only with physiological edema, and a woman can remove them completely or at least reduce them. But pathological edema requires mandatory medical care, as they are dangerous for the development of complications.

Diet

The restrictions apply mainly to salt and "harmful" products, in which there is a lot of it - smoked meats, marinades, semi-finished products and canned food. The recommended dose of table salt per day is 1.5 g. If you reduce the amount of sodium entering the body, excess fluid will be more quickly excreted by the kidneys.

It is recommended to lean on products that have a mild diuretic effect. These include most fruits and vegetables - carrots, beets, cucumbers.

Drinking mode

It is very important to drink at least a liter of water per day, and preferably one and a half, in the absence of contraindications. It will not be possible to avoid edema with a decrease in this volume, because water is needed to replenish the amount of amniotic fluid, remove metabolic products and prepare the body for the upcoming birth.

Case study:

A pregnant woman went to the doctor with complaints of periodic swelling and hot flashes. She has a history of nephrolithiasis, the results of the latest tests are normal. Canephron was prescribed, a low-salt diet, half-bed rest was recommended. When edema appears, lie with your legs elevated, placing a pillow under them, or on your left side.

Physical activity

Dosed physical activity allows you to remove swelling by at least half. Simple exercise and walking help improve blood circulation, as contracting muscles push blood out of the veins, preventing them from overflowing and thereby making the heart work easier.

To remove swelling from the legs, it is enough to perform exercises every 2 hours for 5-10 minutes. Pregnant women especially benefit from swimming, yoga, and exercise balls.

Sign up for an online consultation to learn more about how to get rid of swelling during pregnancy. Our doctors will remotely tell you about the most effective methods in relation to your case and tell you what to do. Specialists work for you 24 hours a day.

Treatment

To relieve swelling and prevent their occurrence in the future, various drugs are used.

With gestosis, antispasmodics, anticonvulsants, sedatives, as well as drugs to reduce pressure are prescribed. Women with diagnosed kidney pathology are prescribed diuretics, xanthines, potassium preparations, and antithrombotic agents.

With varicose veins, phlebotonics, anticoagulants, and compression therapy are effective. High blood pressure is reduced with the help of vasodilators, calcium channel blockers, alpha-2-agonists.

FAQ

What are the dangers of swelling during pregnancy?

+

In the later stages, edema can be a sign of preeclampsia, a very dangerous pathology for both the mother and the child.

Can hands swell in the second trimester of pregnancy in the heat? This is fine?

+

Yes, both hands and feet can swell in the second trimester. High temperatures are one of the reasons for the formation of edema.

How does swelling appear in the third trimester?

+

In the later stages, mainly the legs swell, and especially the feet. They swell most noticeably in the afternoon and in the evening.

Expert opinion

Edema during pregnancy is an almost inevitable companion of a woman "in an interesting position." If there are no pathologies, then there is no reason for concern, you just need to slightly adjust your lifestyle. But this does not cancel planned visits to the gynecologist and regular tests. Remember that you can not drink medicines without a doctor's prescription, so as not to harm yourself and the child.

We publish only verified information

Article author

Menshikova Maria Viktorovna obstetrician-gynecologist

Experience 38 years

Consultations 1816

Articles 91

Specialist with extensive practical experience. He has a certificate of a mammologist, a certificate of professional certification. Participates in foreign business trips and individual training programs (Los Angeles).

• 1982 - 1986 NPO MONIIAG - obstetrician-gynecologist
• 1987 - 1989 VNITs OZMIR - obstetrician-gynecologist
• 1989 - 1992 departmental polyclinic st. Moscow - Kurskaya - obstetrician-gynecologist
• 1992 - 2001 NPO MONIIAG - obstetrician-gynecologist
• 2007 - 2008 NP KMIKM - doctor administrator
• 2009 - 2013 Pereslavl Central District Hospital, women's consultation - obstetrician-gynecologist
• 2020 to present Teledoctor24 LLC - doctor - consultant (gynecologist)

Edema during pregnancy

• Phlebology Center >
• Pregnancy and varicose veins >
• Edema during pregnancy

Article content:

1. Pregnancy and edema
2. Why does swelling appear during pregnancy?
3. When does edema occur during pregnancy?
4. What factors can affect the appearance of edema during pregnancy
5. What can I do to get rid of swelling during pregnancy?
6. Questions from patients about edema and pregnancy

Pregnancy and Edema

Swelling during pregnancy is normal because the body produces approximately 50% more blood and body fluids to meet the needs of a developing baby.

Edema during pregnancy

Edema during pregnancy occurs on the hands, face, legs, ankles and feet.

Why does swelling occur during pregnancy?

This extra fluid retention is needed to soften the body, allowing it to expand as the baby develops. The extra fluid also helps prepare the pelvic joints and tissues for reopening for childbirth. Additional fluids make up approximately 25% of a woman's weight gain during pregnancy.