When should i worry about swollen feet in 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

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.

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.

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.

Swelling of the hands

Quite often hand edema 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.

Mucosal and skin edema

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.

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.

- 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 harder 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.

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.

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.

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.

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.

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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. 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, dropsy of pregnancy develops .

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)
2 Stages of dropsy - swelling of the legs and anterior abdominal wall of the abdomen
Stages of dropsy - swimming stages - swelling , abdomen, hands and face
Stage 4 dropsy - generalized edema

Below we will give you additional tips to reduce 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 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.