Swelling of legs during pregnancy
Swelling of legs is a common condition during pregnancy and is often innocuous. However it may also be a harbinger of serious underlying problems. Almost all pregnant women at some time or other would have had swelling of their legs. Though it is mild most of the times, at times the legs can swell up to serious proportions.
Most women at least develop some swelling in their legs during the second and third trimester of pregnancy. This swelling is most commonly present over the ankles and may rise up to shin. If you keep your finger pressed over this area you will find a pit developing. This is called as pitting pedal oedema. There is another variant of swelling in legs called non pitting pedal oedema. Non pitting pedal oedema has no relationship with pregnancy and hence will not be discussed here. This swelling is typically present towards the end of the day and elevation of legs reduces the swelling.
The commonest cause of swelling of legs in pregnancy is due to reduces venous return from the legs. With the uterus growing in size, it presses on the major blood vessel which carries blood from legs to the heart. Pressure over this vessel occludes it and causes plasma to leak out of the capillaries due to increased pressure in the veins.
Swelling of legs is also seen in many conditions associated with pregnancy. Swelling of feet is commonly seen in hypertensive disorder of pregnancy (High B.P). It is also commonly seen with anaemia, low protein states, kidney diseases and cardiac diseases.
Although swelling of feet may be associated with any of the above conditions, often no cause is apparent in spite of detailed investigations.
Swelling of legs has no no specific treatment. General measures like plenty of oral fluids are advised to keep the kidneys in good shape. Some medicines are also known to cause swelling of feet, so a careful history of medication must be obtained from the expectant mother. If there are any of the associated conditions mentioned above specific treatment must be initiated. Treatment of anaemia or hypertension provides sufficient relief to the swelling. Eating a low sodium diet will also reduce the swelling.
Women, who present with swelling of legs and no obvious disease, generally need only reassurance and supportive measures like low salt diet and elevation of legs. Majority of women fall in this category and hence swelling of feet should not be so worrisome in these women. However any alarming signs like breathlessness, excessive swelling, swelling of fingers and hands, blurring of vision, chest pain and pain in the right upper abdomen should be promptly recognised and women should present immediately to a health care facility. Swelling of feet in presence of any of these symptoms must be taken seriously and immediate treatment must be begun.
The bottom line: Swelling of legs in pregnancy is a very common disorder in pregnancy and hence does not warrant extensive investigations and treatment. But swelling in presence of alarm symptoms must be attended to quickly.