Pregnancy Swelling – How Common Is It?

There are so many changes the body undergoes during pregnancy and it includes pregnancy swelling.

Approximately 75% of all pregnant women experience mild swelling during their pregnancy. Some swelling in various parts of the body is a very normal occurrence of pregnancy. Although more prevalent during the third trimester, Oedema can occur at any time throughout pregnancy.

Oedema (swelling) is common during pregnancy because of accumulated fluid in body tissues. It typically involves the lower extremities but occasionally appears as swelling or puffiness in the face or hands. This happens because during pregnancy the body releases hormones that allow the ligaments to relax in the birth canal. The ligaments in the feet also relax, causing the foot to lengthen and widen. Many will complain of a shoe size increase by one or two sizes. In most circumstances, this flattening and widening of the foot is benign and no problems result. Water retention is also common during pregnancy, which can add to the swelling where the foot can sometimes turn a purple or blue colour.

Causes of Swelling in pregnancy

During pregnancy, as your baby grows, more pressure is put on the veins in your legs. The vena cava is the large vein that returns blood to the heart from the limbs. The pressure on the vena cava from the growing uterus slows the flow of blood and this can result in swelling of the feet and legs.

Another reason is, your blood volume increases by about 50% during pregnancy. Your body is producing and retaining more fluids when you are pregnant. This can result in fluid retention inside the body, which results in swelling.

In addition, discomfort is also evident because of an increased level of the hormone progesterone, which causes the kidneys to retain more sodium during pregnancy. The extra sodium in the body holds water and leaves you feeling bloated, the same way you feel before your period

Clinically, pregnancy oedema can be divided into three classification:

  1. Mild oedema: obvious oedema appears in the legs and feet but can disappear after rest.
  2. Moderate oedema: oedema extends to the thighs and vulva or even involving the abdomen.
  3. General oedema: sometimes accompanied with ascites (accumulation of fluid in the abdomen).

What are the effects of Pregnancy Swelling on your feet?

There are common foot conditions amongst pregnant women which includes over-pronation, leg cramps, varicose veins and leg or foot oedema which may cause foot pain. Foot pain during pregnancy is debilitating. Most often attributed to some level of oedema, foot pain can occur at any stage of pregnancy but most often occurs during the second half of the gestational period. This is due to extra pressure exerted on to the feet by weight gain.

Prevention & treatment of Oedema during Pregnancy

  • Try to elevate your feet as often as you can. If you have to sit for long periods of time, place a small stool by your feet to elevate them.
  • Don’t walk around barefoot: Wear a supportive shoe, one that has a rigid sole and bends only where the foot bends (at the toes)
  • Do not cross your legs or ankles while sitting.
  • Wear shoes and socks that are spacious and do not constrict the feet. Wear comfortable shoes – perhaps shoes that are larger than your usual size.
  • Dry your feet and between toes after showers: Increased moisture between your toes can lead to skin breakdown and eventual ulceration.
  • Have your feet measured regularly throughout your pregnancy to account for size alterations.
  • If sitting or driving for long periods, make sure you stand and walk about occasionally to aid circulation.
  • Exercise regularly to promote overall health; walking is the best exercise.
  • Drink plenty of water for approximately 8 glasses per day to keep the body hydrated. This also helps the body retain less fluid.
  • Avoid foods high in salt, which tend to promote water retention.
  • Vitamin C can improve lymphatic circulation.
  • B complex Vitamins and in particular vitamin B6 can reduce water retention.

Swelling is usually the same in both feet. If one foot seems worse than the other this may be a sign of a vascular problem and you should get medical advice as soon as possible.

Pregnancy Oedema and Preeclampsia

Oedema is common during late pregnancy.The problem usually is worse at the end of the day and in warm weather. Minor swelling is normal but if blood pressure climbs and protein enters the urine, there is a danger of preeclampsia, a potentially serious complication of pregnancy.

The relationship between oedema and preeclampsia is often misunderstood. Many pregnant women are under the impression that swelling and water retention is an inherently dangerous condition to them and their unborn child. This, however, isn’t the case at all. In fact, treating Oedema during pregnancy is quite normal. Oedema is a symptom of preeclampsia; however, having Oedema doesn’t mean that your child is in danger due to the complication.

If you have this condition, you will need to be more carefully monitored to ensure that all your other vital signs are normal and that you haven’t developed blood pressure problems. Many women experience pregnancy induced oedema with no complications besides physical discomfort. However, be aware of the possibilities and keep your eye on your condition closely to ensure that it doesn’t become a problem as your pregnancy progresses.

Risk factors for preeclampsia include:

  • Chronic hypertension
  • Personal or family history of preeclampsia
  • Age < 17 or > 35
  • First pregnancy
  • Multiple pregnancy
  • Diabetes
  • Vascular disorders
  • Hydatidiform mole
  • Abnormal maternal serum screening results

What you should do?

  • Know baseline blood pressure (blood pressure prior to pregnancy), learn what it means, and ask, “What is my blood pressure?” at each visit.
  • If you are told “It’s fine,” repeat, “What is my blood pressure?”
  • If you had preeclampsia before or if you have chronic high blood pressure, consult a specialist, a high risk OB, or a perinatologist, about your pregnancy.
  • Women who have had preeclampsia in a previous pregnancy should request a full screening by a perinatologist to rule out any underlying disease or problems, such as chronic hypertension, autoimmune disorders, renal disease, etc.
  • Women with a previous history of preeclampsia should have subsequent pregnancies supervised by an obstetrician or a perinatologist. The single large risk factor for getting preeclampsia is a history of having had it before.
  • If you are inactive or have a higher-than-average body mass index (BMI), make sure to exercise moderately and get yourself in the best shape you can.
  • You can buy your own blood pressure monitor at most pharmacies.
  • Keep a log of your blood pressure, taken at the same time each day, if possible, and in the same position. Share it with your care provider.

Home blood pressure monitoring should not replace prenatal visits, nor should a “normal” reading mean ignoring symptoms that may be markers of preeclampsia. Home blood pressure monitoring should only be used to help the mother be more proactive in her care.

Bear in mind:

Try not to let pregnancy swelling oedema on different parts of your body get you down. The sight of your swollen parts will probably add to your feeling of negative physical change, but oedema is a temporary condition that will pass soon after you give birth.

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