Swollen ankles during early pregnancy

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

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.

Edema during pregnancy | Nutriclub

What you need to know about edema: why they appear, how to deal with them, how to distinguish ordinary physiological edema from a symptom of a serious illness

It is believed that edema inevitably accompanies the pregnancy of most women - you just need to endure their unaesthetic appearance. However, swelling can be a signal of health problems and pose a danger to both the expectant mother and the development of the fetus. Nutriclub understands when to worry if you have swelling.

Edema - excessive accumulation of fluid in the interstitial space - occurs quite often in pregnant women. Swelling can occur at any time and on different parts of the body.
Edema on the face (especially bags under the eyes and severe swelling of the eyelids) are especially noticeable and cause maximum dissatisfaction, because they directly affect the appearance.
Very often, pregnant women have swollen legs, especially after a long walk. That is why it is so important to get comfortable shoes for the entire period of pregnancy.
Hands tend to swell in women who work at a computer or do needlework. Rings begin to press, fingers look like “sausages”. In such cases, you need to temporarily abandon jewelry.
Pregnant women often mistake swelling of the nasal mucosa for a runny nose or allergies. The latter is more likely because allergic reactions tend to get worse during pregnancy. Also in pregnant women, due to changes in hormonal levels, a condition called rhinitis of pregnancy can develop, which is accompanied by severe nasal congestion. It is better to take tests and be sure to discuss the situation with a doctor who will prescribe a drug that is allowed during pregnancy. Ignoring nasal congestion is not recommended - breathing problems in the mother can make it difficult for oxygen to reach the child.

All these edemas can be both physiological and pathological.

Physiological edema of pregnant women

Physiological usually do not cause complications. They are explained by natural changes in the body of the expectant mother: the uterus puts pressure on neighboring organs, slowing down blood circulation, and sodium accumulates in the blood - it slows down the excretion of fluid from the body. At the same time, during pregnancy, the total amount of fluid circulating throughout the body almost doubles (part of it is contained in the amniotic fluid and placenta).

At the same time, a woman's hormonal background changes, which may be the cause of the legendary “salty” craving, which, in turn, provokes thirst and excessive fluid intake.

Summer heat or stuffiness in transport and premises, physical overload also affects health and appearance.

Physiological edema is considered natural at any stage of pregnancy - and does not pose a threat to the woman's health.

But at the first sign of swelling, you should definitely contact your obstetrician-gynecologist. The doctor will prescribe the necessary examinations and tests to exclude pathological edema, indicating health problems and complications of pregnancy.

Pathological edema during pregnancy

Pathological edema in the early stages may signal hypothyroidism - a condition in which there is a lack of thyroid hormones in the body. Doctors try to identify the disease before the appearance of swelling - pregnant women with a deficiency or excess body weight, with severe toxicosis, a blood test for thyroid hormones is prescribed. If the results are not normal, treatment is prescribed.

Also, starting from the first trimester, edema may appear due to problems with the kidneys. It is very important to take a urine test every two weeks, as recommended in the antenatal clinic. Erythrocytes, high leukocytes, a protein that should not be in the urine - a reason for referral to a urologist and ultrasound of the kidneys. It is important to exclude an infection in the kidneys, and if it is diagnosed, it should be treated qualitatively. Otherwise, premature obstructed labor or the birth of a child with a low weight are possible.

Starting from the 20th week, swelling may indicate varicose veins. Circulatory disturbance due to uterine pressure leads to the formation of "knots" and pain in the legs. If you suspect varicose veins, you will be referred to a phlebologist who will give the necessary recommendations.

Edema also accompanies heart failure, which is considered a serious complication of pregnancy. In this case, the appearance of edema is preceded by shortness of breath and cyanosis of the mucous membranes.

However, most often, pathological swelling indicates late toxicosis - gestosis. This is a problem in the third trimester of pregnancy, but the first signs can begin to appear between the 18th and 20th weeks. Preeclampsia almost always requires the help of a doctor and the presence of a pregnant woman in a hospital.

What is gestosis and why is it dangerous?

However, gestosis, in addition to edema, has other symptoms: high blood pressure, protein in the sea (it is normally absent), nausea, vomiting, headaches, convulsions, fever, drowsiness, or, conversely, severe arousal.

There are four degrees of preeclampsia. The first degree is known as dropsy of pregnant women, it is mainly expressed in edema. The second degree is edema, protein in the urine, a violation of pressure. The third degree of preeclampsia is called preeclampsia. It is characterized by a decrease in cerebral circulation and even hemorrhage. In the most severe, fourth stage of the disease, convulsions (eclampsia) are observed. A pregnant woman may have a stroke or placental abruption.

Thus, even if everyone around them says that edema is completely natural, and they do not cause discomfort to the pregnant woman herself, it is very important to inform the doctor about the first appearance of swelling - precisely in order to make sure that the edema is physiological, and not pathological, and no complications for the development of the fetus and the process of childbirth will not entail.

When should a pregnant woman see a doctor immediately?

The following problems can be considered the reason for an urgent visit to a doctor:

swelling visible already in the morning, immediately after getting up;
edema accompanied by high blood pressure;
edema becomes very severe: it is impossible to clench the hand into a fist, shoes are painful and uncomfortable to wear, it is difficult to open the eyes due to swelling;
regular shortness of breath, palpitations;
headaches do not go away for several days;
regularly experience nausea and vomiting after the 12th week;
Urges for small needs are rare and are accompanied by the release of urine of a dark color;
there are pains in the upper part of the abdomen;
painful convulsions appear;

What helps with swelling during pregnancy?

If, according to the results of examination and analysis, it is established that the edema is physiological, it is possible to get rid of them (or at least reduce them) using the following methods.

Avoid fried, smoked, spicy, pickled and sweet foods. Steam or bake, eat fruits and vegetables regularly.
The use of salt should be limited - it contains sodium, it is he who retains fluid in the body.
Many advise to limit the use of water, even in the form of broth. In fact, it threatens with dehydration. It is better to drink plain water in small sips - and consume most of the daily allowance of one and a half to two liters in the morning. Soda should be excluded.
It is contraindicated to stay in heat or stuffy rooms for a long time.
On the recommendation of a doctor, you can wear special compression underwear, while giving up tight tights, uncomfortable shoes and heels.
Sleep at least 8-10 hours. It is also recommended to lie down every day for 15-20 minutes with legs raised up, do foot massage and foot baths with sea salt.

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© Nutriclub, 2020

How to remove swelling 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;

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:

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.

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:

Study	What the result shows
Analysis of urine	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	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	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
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
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, skin looks glossy - 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.

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

Art.