Swelling during pregnancy is normal and happens because of increasing fluids and bodily changes. Also called edema, this change is usually noticed in the third trimester when the fluids build up in the legs, feet, ankles, hands, and face. This accumulation of fluid is also called edema. The growing uterus also affects blood flow, causing fluid accumulation in the lower extremities. Although it subsides within a few weeks of birth, following some measures could help improve blood circulation and relieves swelling.
The following post will help you know about the causes, symptoms, and treatment management of swelling when pregnant.
When Does Swelling Occur During Pregnancy?
Swelling can occur at any time during pregnancy. Although some women may experience slight edema from the early weeks of pregnancy, it is more common and prominent around the fifth month and third trimester. Swelling may increase as the pregnancy progresses (1).
Pregnant women commonly experience feet and ankle swelling due to various bodily changes. Slight swelling may also be seen in the fingers during pregnancy. Your rings may feel tight, but your fingers may not be visibly swollen.
What Are The Risk Factors And Causes Of Swelling In Pregnancy?
A pregnant woman’s body holds more water. Fluid accumulation increases because the adrenal glands increase the production of the hormones that cause the body to retain water. A decrease in venous return of blood can also cause excess fluid to accumulate in the lower extremities, leading to swelling.
- Gravity causes blood to accumulate in the lower part of the body. Venous pressure may not be enough to drain blood against gravity.
- Pressure on the blood vessels from the growing uterus
The following factors may increase swelling during pregnancy (2):
- Sitting or standing for long periods
- Hot weather
- High sodium diet
- Lack of exercise
- Insufficient water intake
Usual amounts of salt (sodium) in the diet may not cause swelling. Hence, salt restriction is not generally recommended during pregnancy to prevent swelling.
What Are The Symptoms Of Normal Swelling In Pregnancy?
Most pregnant women experience swollen feet and ankles due to physiological reasons, which is normal. The following aspects are usually associated with normal pregnancy swelling (3):
- Swollen feet and ankles
- Swelling improves with leg elevation and rest
- No sudden increase in the swelling
- Gradual onset of swelling
- Worsens in the day and improves at night (while asleep)
What Are The Abnormal Causes Of Swelling During Pregnancy?
Although uncommon, sometimes, the swelling can indicate the following disorders, which require medical care (1):
- Deep vein thrombosis (DVT) is a blood clot formation in the deep veins of the legs. Changes in clotting factors and reduced venous return increase the risk of DVT in pregnancy.
- Preeclampsia is increased blood pressure with proteinuria after 20 weeks of pregnancy.
- Cellulitis is a bacterial skin infection leading to redness and tenderness in the legs.
- Peripartum cardiomyopathy is heart failure occurring in late pregnancy or after childbirth.
Pregnancy edema improves with rest, while swelling due to pathological reasons may not. Further, these conditions can cause more swelling than usual and other symptoms. Hence, contact your doctor if you are concerned about any changes in swelling during pregnancy.
When Should You See A Doctor?
- Severe headaches
- Chest pain
- Blurred vision
- Flashing lights in the eye
- Vomiting in the later trimesters
- Swelling in one leg
- Tender, red, or warm calf muscles on one leg
- Sudden weight gain
- Shortness of breath
- Swollen face and hands
How Is Swelling Treated In Pregnancy?
Normal physiological swelling during pregnancy does not require medical treatment. However, doctors may recommend various conservative measures to reduce the swelling. Physiologic edema can be managed with the following measures (5) (6):
- Avoid standing for long periods. While standing, the veins have to work harder to drain blood against gravity. This may cause reduced venous return and fluid accumulation in the legs.
- Elevate the legs above heart level. When you rest, watch TV, or do other seated activities, keep your feet elevated. This helps decrease the pressure inside the veins.
- Do light exercises, such as walking, regularly. While exercising, the muscles contract and increase venous pressure, improving circulation.
- Do foot exercises such as stretches, bends, or rotations. Moving your feet while standing or sitting improves fluid drainage from the legs.
- Sleep on the left side. Although you can sleep on either side during pregnancy, sleeping on the left side helps avoid pressure on the inferior vena cava, enabling blood drainage from the legs to the heart.
- Wear comfortable socks and shoes. Avoid shoes with tight straps and socks with tight bands as they may worsen swelling by blocking the circulation and increasing the risk for blood clots.
- Wear loose clothing. Avoid tight clothes, especially around the legs. They may restrict the normal draining of the blood in the venous system.
- Wear compression socks. Using 15–20mmHG knee-length compression socks may help increase the pressure in the legs and enhance circulation.
- Immerse your feet and ankles in cool water. Dip your feet and ankles in cool water for 20 minutes a few times a week. You may use a large bowl, bathtub, or pool for this. Ensure that the water is not ice cold.
- Use bandage on the legs: Bind your feet and legs with inelastic or elastic bandages to help improve circulation. Bandages can exert more pressure than stockings. Hence, you may bandage the foot and then use stockings.
- Try foot massage: Manual lymphatic drainage (MLD) massage or manipulating the soft tissues in the legs with massage can help drain excess fluid to the veins. Foot massage in the later weeks of pregnancy helps improve circulation.
- Try reflexology: Applying pressure on the reflex points and specific massage can help reduce swelling. Also, try alternative medical therapy from authorized practitioners.
Swelling is treated when caused by underlying conditions such as blood clots and preeclampsia. In such cases, swelling may improve as the underlying cause resolves. Diuretics (water pills) are usually not recommended to treat physiologic pregnancy swelling since they may affect the pregnancy outcomes (7).
Consult your doctor before taking any alternative medicines to relieve pregnancy swelling since most medications are not regulated.
Physiological and pathological conditions can cause swelling in pregnancy. Seek medical care to know the exact cause of swelling and treat it accordingly. Practicing conservative measures, such as resting and elevating legs, can improve foot and ankle swelling. Always seek prompt medical care if you experience sudden severe swelling and other concerning symptoms.
- Swelling During Late Pregnancy.
- Swelling in Pregnancy—When to Worry and When Is It Normal?
- Swelling During Pregnancy.
- Swollen ankles, feet and fingers in pregnancy.
- 5 ways to manage swollen legs and feet during pregnancy.
- Treatment of Leg and Foot Edema in Women.
- Charlotte Olesen et al.; (2001); Effect of diuretics on fetal growth: A drug effect or confounding by indication? Pooled Danish and Scottish cohort data.