Why do your feet swell during pregnancy?
A pregnant woman's body retains more water and sodium - this is necessary for increased blood volume and nutrition for the child. Under the influence of hormones, the walls of blood vessels become more permeable, and some of the fluid leaks into the tissue. From the middle of the term, the growing uterus compresses the inferior vena cava and pelvic veins, which is why blood flows from the legs worse, especially when lying on the back. Add long periods of standing, heat and tight shoes - and by evening your feet swell noticeably. In the morning after rest, such swelling usually disappears.
- Physiological water and sodium retention
- Increased permeability of the vascular wall
- Compression of the pelvic veins by the growing uterus
- Prolonged standing and sitting
- Hot weather
- Tight shoes and clothing
How to distinguish safe edema from dangerous ones
Physiological edema appears towards the end of the day, is symmetrical, located on the feet and legs, leaves a dimple when pressed and disappears after a night's rest. You should be alarmed by swelling that occurs in the morning, covers the face, eyelids and hands, grows quickly and is accompanied by a sharp weight gain. The combination of edema with high blood pressure and protein in the urine is especially important - these are signs of preeclampsia, a condition dangerous for both mother and child. Unilateral swelling of the lower leg is a separate issue: it requires exclusion of thrombosis.
- Safe: in the evening, symmetrical, on the legs, disappears overnight
- Dangerous: morning, on the face and hands, rapidly growing
- Sudden weight gain in a few days
- Combination with pressure 140/90 and above
- The appearance of protein in the urine
- Unilateral swelling with pain - suspicion of thrombosis
What examinations are needed
At each appointment, the pregnant woman’s blood pressure is measured and her urine is checked: these two indicators make it possible to recognize preeclampsia in time. When edema appears, the doctor assesses weight gain, examines the legs, face and hands, and prescribes a general urine test and quantitative determination of protein. A general blood test and biochemistry help evaluate the functioning of the kidneys and liver. If the swelling is one-sided, painful, accompanied by redness, an ultrasound scan of the leg veins is prescribed. For chronic heart and kidney diseases, a therapist is involved.
- Regular blood pressure measurement
- General urine analysis and determination of protein in urine
- Weight gain control
- General blood test and biochemistry
- Ultrasound of the veins of the lower extremities for asymmetry
- Consultation with a therapist for heart and kidney diseases
What helps with physiological edema
Sharply limiting fluid is not necessary and is even harmful: dehydration impairs blood flow in the placenta. You should drink according to thirst, evenly throughout the day. It is useful to rest with your legs elevated several times a day, sleep on your left side, wear comfortable shoes without heels and compression stockings selected by your doctor. Cool foot baths, swimming and walking help. You shouldn’t completely eliminate salt, but you don’t need to over-salt or overuse smoked meats and semi-finished products. Diuretics should not be taken on their own during pregnancy.
- Drinking according to thirst, without sharp restrictions
- Rest with legs elevated for 15–20 minutes
- Sleeping on your left side
- Compression hosiery as prescribed by a doctor
- Comfortable flat shoes
- Diuretics - only as directed by a doctor
When edema requires hospitalization
The combination of edema with high blood pressure and protein in the urine is the basis for an urgent assessment of the condition in the hospital. Preeclampsia can progress rapidly and lead to seizures, liver and kidney dysfunction, and placental abruption. The woman is hospitalized, monitored for blood pressure and tests, monitors the condition of the child and decides on the timing of delivery: the only radical way to cure preeclampsia is the birth of a child. Hospitalization is also necessary for suspected deep vein thrombosis and severe heart or kidney failure.
- Edema with pressure 140/90 or higher
- The appearance of protein in the urine
- Headache and blurred vision
- Pain in the right hypochondrium
- Suspicion of deep vein thrombosis
- A sharp deterioration in the child's movements
