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When to Worry (and What’s Perfectly OK)

In the early pregnancy, you may beam from the inside out with bright, rosy skin and hair that brilliantly glistens for days. Then, one day, something takes the wind out of your prego-beauty sails — you look down and don’t even recognize the two extremely puffy cankles beneath you.

Unfortunately, swelling falls into that perfectly normal category of pregnancy side effects. In fact, most expecting mamas experience it. But why?

Let’s look at what causes swelling during pregnancy and offer some tips to beat the bloat with comfort and confidence.

And, a note of caution: There are a few instances in which swelling during pregnancy is concerning. We’ll also explain when it could be a sign of a more serious health condition.

During pregnancy, your body does some pretty herculean things, and there’s a lot that, well, increases. One of them is the sheer amount of fluid in your body. While pregnant, your total body water volume can increase by up to 8 liters— that’s over 33 cups!

Meanwhile, your plasma volume leaps 30 to 50 percent, which means your total blood volume increases as well.

So, where does all that fluid go? Good question.

Some of the water stays within your cells to help them function. The rest accumulates outside of your cells to enhance oxygen delivery, clear waste, and control electrolyte flow.

The increase in plasma is in response to the growing needs of the placenta and your maternal organs, as your blood volume increases to deliver all that your baby needs to develop.

As your little one inches closer to birth in the third trimester, your blood volume reaches its peak. Hint: That’s why your swelling (among other slight unpleasantries) can peak around this time.

But that’s not all.

The massive increase in body fluids during pregnancy is coupled with increasing sodium levels. And most of us have seen the effects of what a little too much takeout pizza can do.

Sodium affects how your body absorbs and processes water. Even the slightest rise in sodium may cause you to feel the power of the “puff.”

It’s completely normal to shed a little tear the day your rings and favorite heels don’t fit anymore (sigh). A little gradual swelling in your fingers, legs, ankles, and feet throughout pregnancy is part of the journey.

You may find that your swelling tends to worsen toward the end of the day. This is because the extra fluid in your body can gather in the parts of your body farthest from your heart. A hotter, humid day or a lot of standing can contribute to some normal swelling, too.

Moving into the second and third trimesters, more pressure from your little one’s growing size — in addition to more blood volume — may further affect blood flow in your legs, ankles, and feet, causing you to experience even more swelling.

Tips to relieve normal pregnancy swelling

Sometimes, swelling may be as inevitable as that supersonic sense of smell and burning indigestion that you take in stride with the pure joys of pregnancy. However, here are a few things that you can do to help prevent or ease it.

• Elevate your feet at a level above your heart throughout the day, as this helps the fluid circulate back to your heart.
• Drink more water to flush extra fluid and sodium out of your body.
• Wear compression stockings to improve circulation, especially if you’re taking a long flight.
• Avoid being outdoors in very hot and humid weather.
• Take frequent breaks to elevate your feet when standing for long periods.
• Avoid heels and wear comfortable, breathable, and supportive shoes.
• Eat more foods with potassium, such as bananas and avocados, to flush out sodium and increase urine production (yes, even more).
• Limit high salt foods, such as prepackaged meals, fast food, and chips.

We know every mama bear wants to know when to panic. The answer? Never. Panicking only boosts your emotional and physical stress. Instead, feel empowered by learning when to call your OB-GYN or midwife about swelling.

The two most concerning conditions during pregnancy that can cause swelling are preeclampsia and a blood clot.

First thing to remember: These conditions aren’t common, but the risk is real during pregnancy. Therefore, it’s important to be aware of them.

Secondly, swelling associated with these conditions is different than the normal, gradual swelling you may experience over the course of your pregnancy.

Here’s how the swelling is different.

Preeclampsia

Preeclampsia only affects about 5 percent of pregnant women, usually only after the 20th week. The following are three main symptoms of this disorder:

• high blood pressure
• protein in the urine
• edema (a fancy word for swelling caused by excess fluid in the body)

Labs may also show abnormalities in liver enzymes and lower than normal platelet levels.

This relatively rare condition can have devastating consequences for mom and baby if not treated immediately, so it’s important to be aware of the symptoms — and swelling is one of the major ones.

Significant swelling in your hands, face, or around your eyes that comes on suddenly or gradually becomes worse should alert you to call your OB-GYN. If your swelling appears “pitted” — meaning when you push on your skin, an indentation remains — this is also concerning.

In preeclampsia, swelling might be accompanied by a persistent headache, vision changes, abdominal pain, and sudden weight gain. If you have any of these symptoms, call your OB or midwife immediately. They may advise you to go to your nearest emergency room.

Blood clots

Pregnancy is a risk factor for blood clots in the leg, thigh, or pelvis called deep venous thrombosis (DVT). A 2017 review states that pregnancy alone increases a woman’s risk of DVT fivefold. The risk is consistent throughout every trimester and even up to 12 weeks after delivery.

DVT is a serious condition during pregnancy and warrants immediate treatment, as it may cause a pulmonary embolism (PE), which can be fatal.

To protect mom and baby, it’s important to catch a DVT by knowing the symptoms. Swelling affecting only one leg is a big one.

Swelling related to DVT often occurs with other symptoms affecting the same area, such as:

• significant pain
• tenderness
• redness
• warmth to the touch

If you have any of these symptoms, call your OB or midwife immediately and follow their direction.

Reducing normal pregnancy swelling is nice but not always possible — and that’s OK.

It’s more important to do what you can to prevent serious complications like preeclampsia and blood clots. Again, though, prevention isn’t always possible and early recognition is key. That said, here are some tips that might decrease your risk.

How to lower your risk of preeclampsia

A limited number of studies have demonstrated proven ways to prevent preeclampsia.

While supplementation with vitamins C and E has been researched as a possible preventive measure, a study in 2007 concluded that antioxidant supplementation with these vitamins shouldn’t be recommended for preeclampsia prevention during pregnancy.

Moreover, while some studies have demonstrated a possible connection between prenatal physical activity and a reduced preeclampsia risk, more studies are needed to confirm this relationship.

It’s most important to know your risk factors so your obstetrician can monitor you more closely if necessary.

Some risk factors for preeclampsia include:

• chronic high blood pressure before pregnancy or during a previous pregnancy
• kidney disease before pregnancy
• personal or family history of preeclampsia
• having overweight or obesity
• having a multiple gestation pregnancy (more than one baby)
• being over age 40
• being pregnant with your first baby
• pregestational and gestational diabetes
• being of African American ethnicity

For women with a history of preeclampsia, low-dose aspirin has been cited as an effective secondary prevention strategy. Aspirin to prevent preeclampsia in women with a high risk but no personal history is still under debate.

How to lower your risk of blood clots

Like preeclampsia, preventing blood clots during pregnancy, childbirth, and the 3-month period afterward starts with knowing your risk factors, such as:

• personal or family history of blood clots
• personal family history of a blood clotting disorder
• history of a cesarean section, also known as a C-section
• immobility or long-term bed rest
• certain pregnancy or childbirth complications
• having diabetes, heart disease, or a lung condition

Your OB or midwife can work with you to help reduce your risk by developing a personalized prevention plan. Here are some easy everyday things you can do, too:

• drink plenty of water
• move your legs or get up at least every 1 to 2 hours if you’re sitting a lot
• exercise as recommended by your doctor
• use compression socks or stockings if recommended by your doctor
• take prescribed medications as directed

If growing feet coincide with your growing belly, you’re certainly in very good company. There’s a normal level of swelling that affects most expecting ladies.

Normal swelling can peak in the third trimester, affecting the legs mostly. Some simple elevation and R&R with a big glass of water may be all that you need to calm your cranky cankles.

In rarer cases, swelling is a sign of something more serious. If swelling affects only one leg and is accompanied by pain, redness, or warmth, a blood clot could be a concern, and you should call your doctor.

If you experience sudden or gradually worsening swelling in your face, around your eyes, or in your hands accompanied by high blood pressure, call your doctor immediately. This could be a symptom of preeclampsia, which requires immediate treatment to protect you and baby.

Edema (dropsy) during pregnancy

Edema during pregnancy

It is normal for swelling to occur during pregnancy, especially in the legs, ankles, feet and fingers. It often gets worse at the end of the day. Swelling that comes on gradually is usually not dangerous for you or your baby, but it can be uncomfortable.

If you notice swelling in your hands, ankles and feet, try not to worry. Swelling of the hands, ankles, and feet is very common during pregnancy, especially in the third trimester. Swelling is caused by your body holding on to more fluid than usual. You can get rid of swollen hands, feet and swollen ankles by staying active and drinking plenty of water. Sometimes swollen hands and feet can be a sign of something more serious.

For example, if swelling bothers you in the last trimester of pregnancy and persists on an ongoing basis. During this period of pregnancy, many expectant mothers experience impaired lymph and blood flow. This contributes to fluid retention in the tissues and the formation of edema. As a result, the development of dropsy of pregnancy .

Dropsy during pregnancy

This is a form of toxicosis, in which edema does not disappear from the woman's body, but only increases in size (weight is growing rapidly), in the absence of protein in the urine and normal blood pressure. Violation of water-salt metabolism in the body can pose a serious danger to the health of the expectant mother and baby. In the absence of proper treatment, dropsy can develop into preeclampsia (a severe form of toxicosis). Therefore, at the first signs of this disease, you should immediately go to the hospital.

Dropsy is considered an early manifestation of gestosis, characterized by fluid retention in the body and the appearance of edema.

The following stages are distinguished in dropsy:

• 1 Stage of dropsy - swelling of the legs (stop and lower legs)

• Stage of dropsy - swelling of the legs and anterior abdominal wall of the abdomen

• 9000 3 stage , abdomen, hands and face

• Stage 4 dropsy - generalized edema

Below we provide additional tips for reducing pregnancy swelling and explain when you should still be concerned about swelling during pregnancy.

Causes of swelling (dropsy) during pregnancy

As your baby grows, the expanding uterus presses on the blood vessels in the pelvic area.

Particularly affected are the large veins on the right side (inferior vena cava), which receive blood from the lower extremities. The pressure from your baby and uterus slows down blood flow in this area and causes water to pool from your blood vessels into the tissues of your legs and feet. This can cause swelling of the ankles and legs.

Your hands may also swell towards the end of your pregnancy. If you wear rings, they can put pressure on your fingers and you may have to give them up for a while. Hot weather and standing for long periods of time can also increase swelling.

Up to 80 percent of healthy pregnant women experience edema in late pregnancy.

Diagnosis of dropsy in pregnancy

When should I be concerned about swelling during pregnancy?

Swelling during pregnancy is normal and although annoying, it is usually not a big deal. However, very rarely it can still be a sign of a serious illness.

Edema can develop into a form of toxicosis such as dropsy. This can be determined by a sharp increase in weight. Of course, all pregnant women gain weight throughout pregnancy and swelling can also appear periodically and this is absolutely normal, but it is necessary to ensure that the indicators on the scales do not exceed 200-300 grams per week. Also common signs that dropsy is developing can be called:

• infrequent urination;

• constant feeling of thirst;

• leather gloss;

• puffiness;

• increased fatigue.

If you experience sudden or severe swelling of your hands, face, or feet, call your doctor or midwife right away. This may be a sign of preeclampsia, which is a serious condition that can harm you and your baby and also affect your blood pressure.

Call your healthcare provider if you notice excessive and/or sudden swelling in your feet or ankles, especially if it is accompanied by any of the following signs of preeclampsia:

• Changes in vision, blurred or bright spots

• Pain in the upper abdomen

• Shortness of breath

• Swelling of hands or face more than moderate

• Nausea or vomiting after 20 weeks of pregnancy

Danger of edema in pregnancy

If only one leg is swollen and hot, seek medical attention immediately. There is a small chance it could be due to a blood clot. This is called deep vein thrombosis (DVT) and you will need medical attention.

Symptoms of DVT include:

• pain, swelling, or tenderness in one of the legs, usually the lower leg

• severe pain and warm skin in the area

• red or discolored skin, especially on the calves

Both preeclampsia and DVT can be dangerous for you and your baby, but they can be managed. The sooner you get tested, the better.

Risk of dropsy in pregnancy

What can be done to reduce swelling?

Staying active can help reduce swelling because it stimulates circulation. Try incorporating a couple of walks into your daily routine, or making a few changes to your regular habits, such as getting off the bus a stop early and walking the rest of the way, or taking the stairs instead of the elevator.

You may have heard that diuretics help your kidneys pass water and sodium so you can get rid of excess fluid in your body. However, they are not recommended for normal pregnancy edema, as by washing out important elements, diuretic tablets can harm the fetus.

How to reduce swelling during pregnancy

Your doctor may only suggest that you take them if you have other complications such as heart disease or kidney problems.

Instead of using diuretics, try the following methods for edema:

• Drink plenty of water as this will help your body eliminate excess water.

• Try wearing compression garments, stockings or knee socks. This will especially help relieve your swollen feet and swollen ankles.

• Get a professional foot massage or ask your partner for a relaxing hand or foot massage.

Tips for swelling during pregnancy

• Raise your legs whenever possible as this will improve blood circulation . At work, keep a footstool or box under your desk. At home and in bed, try to lie on your side, as this reduces pressure on the inferior vena cava and is safer for your baby. Place a pillow under your ankles to elevate your legs at night.

• Try not to stand on your feet for too long. Take regular breaks from work. Your employer is required to conduct a risk assessment of your position and do everything possible to reduce the health risks to you and your child.

• Leg exercises can help reduce ankle swelling. Bend the leg up and down 30 times, then twist it eight times in one direction and eight times in the other. Repeat with the other leg. You can apply this technique to your swollen hands as well.

• Swimming in pool for at least 20 minutes may also help.

• Wear comfortable shoes and socks . You can buy socks with specially designed ankle cuffs that won't compress if your feet get a little swollen. Wearing larger, wider, or slip-on shoes can help you feel more comfortable.

Dropsy and preeclampsia during pregnancy

When will swelling disappear?

Try to remember that swelling will not last forever. Like many other discomforts during pregnancy, normal swelling should go away a few weeks after delivery.

If, like some women, you find that you have more swelling after having a baby than during pregnancy, following the same tips and exercises can help you reduce it. It should be gone by the time your baby is six to eight weeks old. Do not forget to be examined in time and visit a gynecologist-endocrinologist during and after pregnancy.

Make an appointment with a gynecologist ►

general medicineVIVI.clinic July 6, 2022 Gynecology, gynecologist, pregnancy management, gynec14 Comments

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 (general)

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;

• preeclampsia

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 95

Specialist with extensive practical experience.

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