Pregnant swollen legs and feet

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

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Your Pregnancy Matters

September 14, 2021

Your Pregnancy Matters

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

The additional weight and hormones you experience during pregnancy can cause swelling and structural changes in your feet.

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.

Swollen ankles, feet and fingers in pregnancy

It's normal to get some swelling in pregnancy, particularly in your legs, ankles, feet and fingers.

It's often worse at the end of the day and further into your pregnancy.

Swelling that comes on gradually is not usually harmful to you or your baby, but it can be uncomfortable.

A sudden increase in swelling can be a sign of pre-eclampsia, a condition that needs to be monitored as soon as possible.

Non-urgent advice: Call your midwife, GP or labour ward immediately if you have:

a sudden increase in swelling in your face, hands or feet
a very bad headache
problems with your vision, such as blurring or flashing lights in your eyes
severe pain just below your ribs
vomiting with any of these symptoms

These could be symptoms of pre-eclampsia, which can lead to serious complications if it's not monitored and treated.

Normal pregnancy swelling

Swelling is caused by your body holding more water than usual when you're pregnant.

Throughout the day the extra water tends to gather in the lowest parts of the body, especially if the weather is hot or you have been standing a lot.

The pressure of your growing womb can also affect the blood flow in your legs. This can cause fluid to build up in your legs, ankles and feet.

What can help to reduce swelling

Try to:

avoid standing for long periods
wear comfortable shoes and socks – avoid tight straps or anything that might pinch if your feet swell
try to rest with your feet up as much as you can
drink plenty of water – this helps your body get rid of excess water
exercise – try to take regular walks during the day or doing foot exercises

Foot exercises

You can do foot exercises sitting or standing. They improve blood circulation, reduce swelling in the ankles, and prevent cramp in the calf muscles:

bend and stretch your foot up and down 30 times
rotate each foot in a circle 8 times one way and 8 times the other way

Get more tips on exercising in pregnancy.

Page last reviewed: 10 March 2021
Next review due: 10 March 2024

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. nine0003

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. nine0003

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: nine0003

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; nine0003

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. nine0003

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. nine0003

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:

The volume of circulating blood should be sufficient for the blood supply to the fetus.
The formation of the placenta and amniotic fluid is impossible with the same amount of fluid. nine0034

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: nine0003

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.

nine0002 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; nine0034
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: nine0003

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:

Study	What the result shows
Analysis of urine nine0003	In kidney disease, protein is found in the urine
Assessment of daily diuresis	Normally, the amount of fluid drunk per day is less than urine excreted by no more than 25%, if this parameter deviates, we can talk about latent edema
Biochemistry of blood nine0003	By the concentration of electrolytes, protein, urea, creatinine, you can evaluate the work of the kidneys and other organs in early and late pregnancy
Weighing	Weekly weight gain is normally up to 300 g
Blood pressure measurements nine0003	A large difference in the results of measurements on different hands indicates the development of preeclampsia
Fundus examination	According to the condition of the veins of the fundus, one can judge the functioning of the cerebral vessels and the entire vascular system. If the veins are dilated, then the blood stagnates, which leads to circulatory disorders nine0003
Blister test	0.2 ml of saline is injected into the forearm area. Normally, the formed blister resolves in 40-60 minutes. Otherwise, there are hidden edema
Ankle diameter measurement	Measurements are taken every week, with increased hydrophilicity of tissues, the circumference of the lower leg increases by more than 1 cm nine0003
Physical examination	The doctor pays attention to the condition and tone of the skin: pallor - problems with the kidneys; cyanosis - pathology of the heart; unnatural shine, tightness, glossy appearance of the skin - dropsy of pregnancy

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. nine0003

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. nine0003

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. nine0003

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. nine0003

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. nine0003

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. nine0003

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. nine0003

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 nine0003

Article author

Menshikova Maria Viktorovna obstetrician-gynecologist

Experience 38 years

Consultations 1816

Art. 46

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)

what to do and how to get rid of edema in the 2nd and 3rd trimesters

A fairly large percentage of women experience edema during pregnancy: moderate edema is observed in 50-80% of pregnant women with a normal pregnancy (1). Often they indicate an excessive accumulation of fluid in the tissues of the body or a violation of the outflow of blood from the pelvic organs - this should not be feared. But there are cases when swelling is the result of health problems. In this case, both the condition of the mother and the condition of the baby are at risk. It is important to consult a specialist in a timely manner and not self-medicate. nine0003

Types of edema

Edema during pregnancy is divided into physiological and pathological. The former are considered natural and do not pose a health hazard. But pathological edema speaks of problems with various organs: for example, the kidneys or the thyroid gland. We will talk about the physiological edema of various parts of the body.

Photo: pixabay.com

Swelling of the legs

The legs most often begin to swell after the fifth or sixth month of pregnancy. Severe swelling is noticeable on the calves, ankles and feet: the upper part of the legs almost never swells. Pregnant women may also experience an increase in leg size due to swelling. This happens under the action of the hormone relaxin, which is responsible for the relaxation of the ligaments. Due to its release, the distance between the ligaments becomes larger and the feet swell a little. (2)

Edema of the face

They occur due to an increase in the level of estrogen in the blood. This hormone is responsible for sexual development, reproductive function and the skeletal system. Facial swelling becomes more noticeable when the level of estrogen becomes higher than normal: the nose, lips, and upper part of the face may swell. But if a pregnant woman has severe swelling under her eyes, this is a reason to seek the advice of a specialist. The so-called bags under the eyes can indicate problems in the functioning of the kidneys. nine0003

Edema of the hands

Quite often, swelling of the hands appears in the third trimester of pregnancy. A woman cannot wear rings, there is a strong tension when clenching her fists, and after sitting work, her hands become very numb. The duration of the manifestation of edema is individual, but if there is, for example, swelling of the hands and face that cause discomfort, you should consult a doctor.

Edema of mucous membranes and skin

A pregnant woman may experience difficulty in breathing without other accompanying symptoms. Mucosal edema is not so common, but it still happens: with a physiological manifestation, you should not be afraid of it. The mucous membranes also swell due to the accumulation of fluid in the intercellular space. A similar thing happens with the skin: traces of clothing remain on it, and the skin itself looks loose and devoid of moisture. If the swelling of the skin covers a large area, and when pressed, a distinct hole remains, it is necessary to visit a specialist. nine0003 Photo: pixabay.com

In these cases, swelling is a natural condition that accompanies pregnancy. But swelling can be the cause of the development of serious diseases. Therefore, it is important to start treatment on time in order to prevent the threat to the life of the mother and child.

When edema occurs

In the first three months of pregnancy, a woman in most cases does not experience edema: they begin to appear in the second and third trimester.

Second trimester

Puffiness appears on the arms, legs and face, most often the hands suffer from edema from 13 to 28 weeks. Fluid retention is often reflected in the face. Swelling appears on the cheeks, nose and upper eyelids. It is necessary to monitor how much fluid is consumed and how much is excreted: if there is very little urine, you should consult a doctor. Such a condition may indicate not only puffiness, but also toxicosis of the second trimester. nine0003

- Edema can appear both in early and later pregnancy due to venous-lymphatic insufficiency. During pregnancy, a restructuring of the hormonal background occurs, progesterone disrupts vascular permeability, and as a result, water is retained in the tissues. Most often, the arms and legs swell, from where it is more difficult for fluids to return, - adds Nina Antipova, obstetrician-gynecologist, gynecologist-endocrinologist .

Third trimester

From the beginning of the seventh month of pregnancy until the ninth month, a woman may experience swelling of the extremities: but most often it is, of course, the legs. The shins, ankles, calves swell much more strongly in the afternoon, with strong pressure, a slightly noticeable fingerprint is formed. Such edema is aggravated by hot weather, eating salty foods, and prolonged standing. nine0003
What to do if edema occurs

Physiological edema affects no more than two areas of the body. For example, hands and feet, or swelling of the eyelids and feet. Usually such edema is not very pronounced and subsides by the next day. In this case, you do not need to worry and consult a doctor: the puffiness will subside on its own. (3)

If a woman feels that breathing is difficult, or edema appears in the early morning and does not disappear the next day, the amount of urine begins to decrease sharply, and, on the contrary, weight increases, it is worth going to a specialist for a consultation. nine0003 Photo: @shvets-production, pexels.com
How to get rid of edema

With natural manifestations of edema, it is important to monitor nutrition, do not include a lot of fried and fatty foods in the diet, and limit salt intake. In case of swelling of the legs, it is worth spending less time in a standing position, giving them a rest.

If it is possible to perform light exercises, do exercises, then it is worth paying attention to physical activity. Despite the fact that during edema water accumulates in the body, it is important for a pregnant woman to drink enough liquid - 1.5-2 liters of purified water. Compression underwear will also help get rid of edema, which alleviates symptoms and helps not only with swelling, but also with varicose veins. nine0003
Medicines may only be used during pregnancy with the permission of a doctor. Therefore, in the event of an increase in symptoms or their prolonged manifestation, you should not drink pills on your own: they should be prescribed by a specialist.

Popular questions and answers

Popular questions were answered by Nina Antipova, obstetrician-gynecologist, gynecologist-endocrinologist, hemostasiologist at REMEDI Reproduction Clinic.

Why are edema dangerous?

- Edema can be a concomitant symptom of other diseases, such swelling is also called pathological. To distinguish it from physiological edema will help the doctor during the examination. That is why it is important to visit a specialist systematically, and not only if necessary. nine0003
After examining the veins of the lower extremities and lymph nodes, the doctor may additionally prescribe medications that improve vascular permeability, as well as wearing compression underwear. If venous-lymphatic insufficiency can lead to deep vein thrombosis of the lower leg, then injections are prescribed. Risk factors include age, obesity, smoking, predisposition to thrombosis, individual characteristics with the onset of pregnancy.

Edema may occur due to preeclampsia. The complication occurs after the 20th week, in the second half of pregnancy: swelling of the extremities and face appears, blood pressure rises, and an increased amount of protein is present in the urine. Preeclampsia occurs due to disruption of the placenta, as a result of which biologically active substances begin to enter the body, which lead to disruption of the cardiovascular system and blood supply to the organs. Complications in preeclampsia can be very serious: liver dysfunction, stroke, coma, placental abruption, bleeding, acute hypoxia, intrauterine death. You can prevent the development of preeclampsia at the first screening at the 12-13th week of pregnancy. It is important to see a doctor regularly. nine0003
Swelling may be the result of a chronic disease. Women with such a diagnosis are registered with specialized specialists who are already familiar with the medical history.

What is the prevention of edema?

To reduce and prevent swelling, it is necessary to review the diet: limit or completely eliminate salty and spicy - seasonings retain fluid in the body.
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