During pregnancy, the legs swell a lot. Treatment of edema during pregnancy: eliminate a dangerous condition. Why do legs swell in pregnant women?

About 80 percent of pregnant women will sooner or later experience edema. Why is this happening, how to minimize the risk of edema and is it worth panicking if they do occur?

Edema is an excessive accumulation of fluid in the tissues of the body. They can be explicit and internal (hidden), have a physiological or pathological nature.

Causes of edema in pregnant women

Pregnancy. Changes in hormonal levels and a growing uterus are factors contributing to the appearance of edema. With multiple pregnancies, the risk of swelling increases significantly.
Emerging or aggravated health problems.
Bad habits.
Overweight.
Improper nutrition.
Prolonged stay in a standing or sitting position.
Age 35 and older.

Swelling during pregnancy, stage

At the first stage, the legs swell during pregnancy: legs, feet.
At the second stage, swelling of the hips and abdomen joins the above.
In the third stage, the swelling spreads to the hands and wrists. The face becomes puffy.
The fourth stage is general edema.

The nature of edema during pregnancy

The physiological nature of edema

Man is 80 percent water. During pregnancy, a woman normally gains 10-12 kg, half of which is water. In the tissues and blood of the expectant mother, the sodium content increases, which retains fluid. With the growth of the fetus, the pressure of the uterus on the small vena cava and ureters increases, which contributes to the deterioration of fluid discharge. Therefore, swelling during late pregnancy is such a common occurrence.

Slight swelling of the legs and feet, which manifests itself closer to the afternoon and passes after a night's sleep, is not a reason for panic. Towards the end of pregnancy, women may experience swelling of the labia. This is also a variant of the norm.

Physiological edema also includes swelling of the tissues of the nose, followed by difficulty in breathing.

The pathological nature of edema

Renal edema during pregnancy

The kidneys of pregnant women have an enormous load. Renal edema can develop due to the onset or worsening of kidney disease during pregnancy. Such edema is localized, mainly on the face: it becomes puffy, the eyelids swell. Swelling of the wrists and hands may also occur.
Disorder of the kidneys is also indicated by the protein that appears in the urine of a pregnant woman.

Cardiac edema during pregnancy

In a pregnant woman, blood volume increases by 40-50 percent. Consequently, the load on the "pump" that makes it circulate - the heart - increases significantly.
Downward tendency is characteristic of cardiac edema. If a woman is in a standing position, then her legs will swell during pregnancy. In the supine position, the abdomen or back will be affected by swelling.
With edema of this kind, shortness of breath, cyanosis of the mucous membranes, persistent heartbeat are also observed.

Internal edema during pregnancy

Internal edema is not visible to the naked eye, but it poses a danger to the development of the baby. The fact is that with a latent form of edema, the uterus, placenta and abdominal wall most often swell. The edematous placenta can compress the vessels of the umbilical cord, which will lead to placental insufficiency.

Puffiness, as a manifestation of gestosis

Gestosis is a complication of the course of pregnancy, which is the main cause of maternal mortality and increases the risk of fetal / child death by 5-7 times in the first week after childbirth.
Severe edema during pregnancy, both external and internal, along with proteinuria and high blood pressure, are classic symptoms of late toxicosis.

Swelling during pregnancy, diagnosis

Daily urine output

During diuresis, the volume absorbed is calculated, taking into account liquid foods and fruits, and the volume of excreted fluids, minus the first morning urine, which refers to the previous day. About 75 percent of the absorbed fluid should be excreted from the body along with urine. A significantly lower indicator indicates that the fluid is retained in the tissues.
For greater informational content, it is recommended to conduct the study for 3 days in a row.

McClure test - Aldrich

In everyday life, it is called blistering breakdown. For the study, a woman is injected intradermally into the inner side of the forearm with 0.2 ml of a sterile solution of sodium chloride at a concentration of 0.8%. As a result, a bump forms on the skin that resembles a lemon peel in texture. Normally, this tubercle resolves in an hour. With latent edema, the time of resorption decreases in direct proportion to the degree of swelling.

The test is carried out on an empty stomach, the patient should be in a sitting or lying position.
Currently, the blister test is rarely performed due to the length of the study.

Examination of the limbs

Swelling may cause numbness or tingling sensations in the fingers and toes.
With edema, the circumference of the ankle increases by a centimeter or more.
When pressing on a swollen limb, the resulting "dent" is not straightened immediately.
Swollen feet give out deep rubber marks after wearing socks or golf.
Swollen hands are indicated by difficulty getting the rings on or off. It is not recommended to wear rings for women who have had finger swelling during pregnancy.

Weight gain tracking

According to WHO standards, weekly weight gain in the second half of pregnancy for women with a normal body mass index should be about 230 grams. Sudden changes in body weight or a set of more than 350 grams may indicate the presence of edema.

Physiological swelling during pregnancy prevention and treatment

Physiological edema does not require medication. In order to minimize the risk of such edema, it is enough to follow simple recommendations.

Healthy eating

Nutrition is extremely important in the fight against edema. During pregnancy, you should exclude all kinds of pickles, smoked meats, spicy foods, carbonated drinks and limit the use of sweets.
The volume of liquid, contrary to popular belief, should not be greatly reduced. For the normal functioning of the body, a pregnant woman needs to consume about one and a half liters of liquid per day, taking into account the first courses and watery fruits. A strong reduction in the volume of incoming fluid can have the opposite effect - the body will begin to "store" water, and the swelling will only intensify. For the same reason, salt should not be completely eliminated from the diet.
It is useful to arrange unloading vegetable and milk days.

An active lifestyle, gymnastics

The only reason to exclude physical activity during pregnancy is the threat of termination. In other cases, light physical activity will only benefit.

To prevent or combat edema, special fitness or water aerobics for expectant mothers, swimming, and not too long walks are well suited. Even a banal daily exercise will bear fruit.
Pregnant women who have sedentary, sedentary work are advised, whenever possible, to raise and put their feet on a chair during the working day for better fluid drainage.
Due to the repeated repetition of the same actions, the hands swell during pregnancy. Therefore, it is advisable to minimize the time spent at the computer, modeling, knitting, etc. Or, as a last resort, remember to take breaks and do hand exercises.
A popular exercise to combat edema, in which a woman lies down on the floor and, raising her legs high up, rests them against the wall. In the second half of pregnancy, it must be modernized by placing a hard roller under the woman's buttocks. Otherwise, due to the pressure of the grown uterus on the small vena cava, the outflow of venous blood will be difficult.
To prevent or combat swelling and relieve the back, you can do the "cat" exercise.

It well reduces the load on the kidneys and the static position in the knee-elbow position. To achieve a tangible effect, you need to perform several approaches daily for 10-15 minutes.
Resting during long periods of pregnancy is most useful on the left side.

Wearing a bandage, compression stockings

A properly fitted band supports the growing pregnant belly in the correct position, which reduces the risk of edema.
Wearing compression golf, stockings or tights will be useful if you are prone to varicose veins, which are often accompanied by edema. A phlebologist will help determine the required degree of compression.
Wear the bandage and compression garments correctly while lying down.

The right shoes

The risk of getting swelling is greater when wearing inappropriate shoes. The right footwear: in size, has a stable heel with a height of 3 to 5 centimeters, stable. There are no straps that tightly tighten the leg.

Getting rid of bad habits

Bad habits during pregnancy can not only harm the health of the baby, but also provoke the appearance of edema.
Nicotine damages all organs and systems of the human body. The closest relationship between smoking and varicose veins, which, in turn, contributes to the development of edema.

Oddly enough, one of the causes of edema is dehydration. The latter is a frequent companion to alcohol abuse.

Body care

In the care of swollen or varicose feet, it will not be superfluous to use specialized cosmetics.
Swelling of the legs during pregnancy can be relieved by foot baths with sea salt. To carry them out, as much salt water is poured into the container, with a temperature not higher than 37-38 degrees, as needed to completely immerse the swollen leg area. The duration of the procedure is 15 minutes. For skin diseases or diabetes, salt baths are prohibited.

Swelling of the legs during pregnancy, what to do? Massage! It is a pleasant and effective way to improve blood circulation. It is necessary to massage the legs in the direction from the feet to the thighs. For the procedure, you can use both special massagers, a washcloth, and just your hands.

Pathological edema during pregnancy, what to do

Do not panic and undergo a medical examination. Based on the test results, the doctor will determine the need and tactics for drug treatment of edema.

Medication for edema

The attitude to puffiness among doctors in the CIS countries differs from the point of view adopted in Europe and America. Foreign doctors prefer to observe, intervening only in situations that really threaten the health of a woman and her unborn child. Domestic doctors often prefer to play it safe and, depending on the results of the examination, prescribe diuretics, vasoconstrictors, antispasmodics and sedatives.

To normalize kidney function, complex herbal remedies are usually prescribed, such as "Kanefron" or "Cyston" in tablet form, paste "Fitolysin". They should be used with caution: the annotations contain rather long lists of side effects. But these drugs relieve renal edema well during pregnancy, reviews of future and successful mothers are confirmation of this.

To strengthen blood vessels, doctors prescribe magnesium preparations, vitamin E, lipoic acid, and against vasospasm - "No-Shpu".
Treatment of edema with gestosis is carried out in a hospital setting. The standard measure is an infusion of magnesia, which relieves swelling, normalizes blood pressure, relaxes blood vessels and muscle muscles. Droppers of drugs based on pentoxifylline improve blood microcirculation.
It is strictly forbidden to use diuretics with suspicion of gestosis!
Nose swelling during pregnancy cannot be treated with the usual vasoconstrictor drops and sprays. But it is also impossible to stay idle: due to the deterioration of nasal breathing, the fetus may receive less oxygen. Doctors recommend to deal with the "runny nose of pregnant women" by rinsing the nasal cavity with saline or sea salt solution.

How to get rid of edema during pregnancy, folk remedies

Traditional medicine is replete with anti-edema remedies. But they can be used only as directed by a doctor, and even then not all. The fact is that some components of the popular renal fees can cause uterine tone and even provoke abortion.

Of the safest folk remedies, a decoction of lingonberry leaf can be distinguished, which has anti-inflammatory, antibacterial, immunostimulating, choleretic, astringent and mild diuretic effects.

Output

Most edema in pregnant women is harmless and does not require treatment. But, at times, puffiness can signal the development or exacerbation of diseases and conditions dangerous for the mother and fetus.

Self-medication of pathological edema can be extremely dangerous, only a doctor should decide how to remove edema during pregnancy, based on the results of the examination.

Edema is the accumulation of fluid in the tissues. During pregnancy, edematous syndrome occurs mainly in the third trimester. Approaches to the study and treatment of edema differ. In some cases, this symptom is considered normal during gestation, in others they speak of the need for urgent treatment. How to distinguish the norm from pathology and what to do if edema occurs?

Causes of edema

Several years ago, edema was considered one of the inevitable attributes of gestosis. All pregnant women with edema were monitored by a gynecologist. Often, the expectant mother was repeatedly hospitalized in the hospital at the slightest change in well-being, was limited in fluid intake, and various drug therapy was prescribed. This treatment regimen did not justify itself. The swelling recurred, and the woman had to endure constant thirst and take many medications. Currently, doctors have abandoned such tactics and completely revised their attitude to edema that occurs during pregnancy.

A well-known fact: the human body is 70% water. Water is both intracellular fluid and blood in the vessels. During pregnancy, the volume of fluid in the body increases due to the growth of the BCC (volume of circulating blood) and other important processes. The tissues accumulate up to 3 liters of water, in the vascular bed - about 6 liters. Only 3 liters is accumulated by the placenta along with the amniotic fluid and fetal tissues. All these processes are considered completely natural and serve one purpose - to ensure the successful course of pregnancy and childbirth.

The total volume of fluid in a woman's body begins to increase for another 7-9 weeks. This process is necessary in order to ensure the normal development of the placenta - a temporary organ that is a conductor and barrier between the mother and the fetus. Placenta formation is completed by 14-18 weeks. By this time, she should be completely ready to take on the function of providing the child with oxygen and nutrients, removing ballast elements. Also, the placenta synthesizes the hormone progesterone and some other substances necessary for the normal existence of a child in the mother's womb.

An important point: for admission to the fetus, the fluid must be in the bloodstream, and not in the tissues of the female body. Only in this form can water get to the baby. Two substances keep water in blood vessels: sodium chloride (table salt) and albumin protein. Their lack leads to the fact that fluid seeps through the vessel wall. Edema occurs - the accumulation of fluid in the tissues.

Where do these elements come from? Albumin comes from food and is processed in the liver. Table salt also comes with food and is excreted by the kidneys. Failure at any of these stages can lead to a violation of the water-salt balance and cause the development of edema.

Interesting fact: in the first trimester of pregnancy, many women are drawn to salty foods. This is due to the lack of its own reserves of table salt, which ensures the balance of water in the body. It is not surprising that many experts recommend that expectant mothers listen carefully to the signals of their body and eat what they want at the moment. Lack of dietary salts can lead to edema and other unpleasant conditions in the long run.

Physiological edema

Currently, isolated edema syndrome is not considered a pathology. It is known that edema occurs in almost all pregnant women and does not always lead to the development of pathology.

Signs of physiological edema:

occur in the second half of pregnancy;
intensify towards the end of the day, after physical exertion, in hot weather;
the condition of the pregnant woman remains stable.

Physiological edema is mild or moderate, localized on the ankles and legs. They are not accompanied by a deterioration in the general condition, including an increase in pressure, pain of any localization and impaired diuresis. Such isolated edema does not require treatment. After the baby is born, the swelling will go away on its own within a few days.

An important point: Only a doctor will be able to distinguish physiological edema from manifestations of serious pathology during a personal examination of the patient.

Diagnosis of edema is not particularly difficult. The doctor presses on the skin on the previous surface of the lower leg, pressing the finger against the bone. Normally, a dimple remains on the skin, which quickly heals. With edema, the skin relief is restored slowly.

A woman herself may notice the appearance of edema on the lower extremities. Usually, expectant mothers complain that their feet do not fit into their usual shoes. It is impossible to put on your favorite shoes or boots with edema. Many women have to wear shoes one size larger until the very birth, and in warm weather they even have to do with simple slippers that do not squeeze their feet.

Pathological edema

The following conditions deserve special attention:

Gestosis

Gestosis is a specific complication associated with insufficient adaptation of the woman's body to pregnancy. Outside of the connection with gestation, pathology does not arise. In the absence of timely therapy, gestosis can lead to the development of eclampsia, cause premature birth, death of the mother and fetus.

The triad of symptoms in gestosis:

swelling;
arterial hypertension (increase in systolic pressure by more than 30 mm Hg and diastolic pressure by more than 15 mm Hg from baseline);
proteinuria (protein in the urine).

Edema is considered one of the first signs of preeclampsia. They occur in the second half of pregnancy, localized on the lower extremities. At first, edema is noted only on the feet and legs, then spreads up to the thighs. In severe cases, there is marked swelling of the arms and trunk. Edema with gestosis occurs against the background of an increase in blood pressure. Protein in the urine is a late symptom and indicates kidney involvement.

The time at which edema appears and the rate at which it develops directly affects the prognosis for this pathology. The earlier the first signs of preeclampsia appeared, the more severe the disease progresses, and the higher the risk of complications.

In the diagnosis of preeclampsia, identification of latent edema is of particular importance:

Ring symptom. Swelling of the hands causes the woman to remove all rings from her fingers.
Pathological weight gain. Normally, the expectant mother should gain 300-500 g per week. An increase in this indicator may indicate the development of latent edema.

Gestosis is a pathology that will go away only after childbirth. Once it has arisen, gestosis will progress, and without treatment it can lead to a sad outcome. For his therapy, the following drugs are used:

Means that enhance urine excretion, improve kidney function and relieve swelling (mainly herbal diuretics).
Drugs that lower blood pressure (selected individually, taking into account the duration of pregnancy, the severity of the pathology and the presence of concomitant diseases).
Sedatives (herbal remedies) to relieve anxiety.
Drugs that improve uteroplacental blood flow (gestosis is often combined with placental insufficiency).

Whenever possible, doctors try to extend the pregnancy to at least 37 weeks. If the condition of the woman and the fetus worsens, swelling increases and blood pressure rises, an emergency delivery is performed (by natural means or by means of a cesarean section).

Kidney pathology

Edema in kidney disease has its own distinctive features:

occur in the morning after a night's sleep;
localized on the face (including bags under the eyes).

For the diagnosis of renal edema, the following studies are shown:

general urine analysis;
bacteriological culture of urine;
Ultrasound of the kidneys.

A therapist or nephrologist deals with the treatment of kidney pathology. The use of salt is limited to 5 g and liquid to 1-1.5 liters per day. According to the indications, antibacterial drugs are prescribed, taking into account the identified pathogen and the duration of pregnancy.

Heart pathology

In diseases of the cardiovascular system, edema has the following distinctive features:

arise in the afternoon;
intensify in the evening, after physical exertion, with overheating;
localized on the lower extremities.

Cardiac edema is very similar to edema in gestosis and often complement each other. It is known that heart disease provokes the development of gestosis in the second half of pregnancy. For diagnostics, it is carried out:

general and biochemical blood tests;
echocardiography;
daily monitoring of blood pressure, etc.

The choice of the method of treatment will depend on the identified pathology and the duration of pregnancy.

Endocrine pathology

Swelling is one of the symptoms of hypothyroidism - a decrease in the function of the thyroid gland. With this pathology, the level of thyroid hormones decreases, and the following symptoms occur:

unmotivated weight gain;
decrease in body temperature;
constant chilliness;
lethargy, lethargy, constant fatigue;
decreased memory;
muscle and joint pain;
constipation;
brittle hair and dry skin.

Hypothyroidism edema affects the lower limbs and face. There is nasal congestion, nasalism due to swelling of the mucous membrane. Swelling of the vocal cords leads to hoarseness. Swelling of the Eustachian tube and middle ear can cause hearing loss.

Hypothyroidism is one of the leading causes of infertility. If a woman succeeds in conceiving a child, there is a high risk of early miscarriage. Pregnancy against the background of hypothyroidism should take place under the constant supervision of a physician. The question of hormone replacement therapy is decided individually.

Varicose veins

Varicose veins of the lower extremities make themselves felt in the second half of pregnancy, when the load on the vessels increases significantly. Swelling with varicose veins is localized on the legs, worse in the evening and after physical exertion. Such edema is accompanied by the appearance of the following symptoms:

pain and heaviness in the legs;
cramps of the calf muscles;
the appearance of spider veins, varicose veins.

Varicose veins pose a high risk of thrombosis and thromboembolism. The longer the pregnancy, the more likely complications are. To prevent dangerous consequences and eliminate unpleasant symptoms, medications are prescribed - venotonics. Wearing compression underwear is recommended. Childbirth also takes place in special knitwear.

Help with edema

First of all, the expectant mother should inform the gynecologist about the edema that has arisen. After examination and examination, the doctor will select the optimal therapy regimen and determine the further management tactics. In most cases, herbal diuretics are prescribed: "Kanefron", "Brusniver", "Kidney tea". These drugs activate kidney function, have a diuretic effect and eliminate edema. The course of treatment lasts 2 weeks. If necessary, taking the drug can be repeated after 2 weeks.

Simple tips to help relieve swelling:

Regulate your daily routine. Get enough sleep, spend more time outdoors.
Do yoga, gymnastics for pregnant women, swimming (if the general condition allows, and there are no contraindications).
Avoid prolonged sitting, standing in one place, or long walking.
Choose shoes that are comfortable and wide enough. Give up high-heeled shoes, tight boots.
Eat well.
Limit salt intake (within reasonable limits). Do not get carried away with pickles and smoked meats.
Drink berry fruit drinks, fruit drinks, weak tea - these drinks "pull" water from tissues and eliminate swelling.
Avoid drinking carbonated and sugary drinks - they retain fluid in the body and increase swelling.

Pregnancy is a condition that causes many metamorphoses in the female body. These changes are not always physiological, it so happens that the expectant mother needs qualified medical assistance in order to normalize the condition. For example, if the ankles swell during pregnancy, this can be both the norm and a pathological abnormality that requires intervention.

Causes of leg edema during pregnancy

Let's look at two types of causes that cause swelling around the ankle bone during pregnancy:

Puffiness due to natural causes (physiological).
Pathological processes that cause swelling.

According to statistics, more than half of women suffer from edema while carrying a baby. In most cases, this is a normal condition that requires observation and careful attention to your well-being.

Natural causes

Massage improves fluid drainage

Natural puffiness can be caused by a number of reasons, all of them are associated with the processes taking place in the body of a woman preparing to become a mother. During this period, the body is rebuilt and makes reserves. The volumes of any fluid in the body of the expectant mother (blood, lymph, intercellular fluid) increase. This is necessary to prepare for the process of childbirth and to form a certain structure of the pelvic floor area, suitable for the birth of a baby.

The supply of fluid will be useful to a woman in the first days after the birth of the baby to start the process of milk production.

The growing uterus and increasing weight by the third trimester begin to put pressure on the organs and tissues below. This makes it difficult for fluid to drain upward from the lower extremities, therefore, it is the legs that are most often swollen.

This edema most often occurs after 22 weeks of pregnancy. It is characterized by a gradual, not sharp increase in the volume of swollen limbs and the weight of the pregnant woman.

The dynamics of stagnation depends on the time of day and season. Legs begin to swell in the evening or in extreme heat in summer, with prolonged sitting or standing. After a long rest (night sleep), the swelling subsides.

The following areas are more likely to swell:

legs (feet, ankles);
hands (hands),
face.

If the swelling spreads higher and does not subside after rest, it is worth telling the gynecologist about this and conducting examinations. The reason for this may be serious pathological conditions of a pregnant woman.

Common Causes

Such a manifestation is possible under the influence of a number of reasons that contribute to the development of edema in principle:

hereditary factor;
unhealthy diet (excessive use of salt and salty foods);
lack of vitamins (especially B vitamins and folic acid);
decreased immunity;
neurosis, a state of stress.

These factors often provoke fluid retention in the body and prevent its outflow.

Pathological conditions

With gestosis, in addition to massage, an examination will be required.

Quite dangerous conditions during the period of bearing a baby can be preeclampsia and preeclampsia, a blood clot.

Gestosis is a form of toxicosis in late pregnancy, it is characterized by an increase in blood pressure and severe swelling. It can be external and hidden, internal.

Gestosis provokes disruption of the work of many organs and systems:

liver;
kidney;
nervous and circulatory systems.

At the same time, laboratory tests show that the permissible norms of protein in the urine are exceeded.

If you do not take action, preeclampsia may develop - a rather dangerous condition, fraught with spontaneous abortion and, in especially advanced cases, death.

It is characterized by a sharp and strong increase in blood pressure, headaches, convulsions.

If one foot is swollen on the right or left, this may indicate the formation of a blood clot. This is a dangerous condition characterized by swelling of the leg from the foot to the knee and lower leg. The skin in this place looks glossy, smooth. Painful touch to the surface of the foot, the entire lower leg and thigh.

These conditions of pregnant women require professional medical intervention and hospital treatment.

What should be alarming

Red spots may appear on the legs with swelling

Sometimes it is difficult for a woman herself to determine the cause of swelling in her legs during pregnancy. In this case, you need to know exactly what edema looks like for natural reasons and what features may indicate pathological changes in the body.

Natural processes can cause slight swelling in the ankle and foot area without affecting the sole and knee area.

It is worth being wary if the legs are swollen so that the protruding bone above the heel is not visible, one leg is swollen, the swelling has developed suddenly, additional symptoms have appeared:

increased body temperature;
reddish spots or streaks in the area of the swelling;
increased blood pressure;
severe swelling in the third trimester.

All this in aggregate or separately is a reason to immediately contact a gynecologist, do the tests recommended by him or go to the hospital.

How to relieve natural leg swelling during pregnancy

In most cases, women suffer from natural swelling around the ankle bone during pregnancy.

eating foods rich in the entire complex of vitamins and minerals;
the daily diet should include protein meals;
reducing or eliminating the use of salt and all foods containing it.

For those whose legs are a little heavier, there is a swelling in the ankle area, doctors usually recommend the following:

Alternation of activity and rest. Walking in the fresh air, small warm-ups, good sleep are necessary.
Change of poses during the day. If the work is sedentary, you need to take breaks and walk or stretch your legs, if the expectant mother works mainly standing, then breaks with rest while sitting or lying are required.
When sitting, you don't need to cross your legs or even your ankles.
During rest and sleep, it is better to place a pillow under the feet to facilitate the outflow of blood and fluid from swollen limbs.
Do a warm-up for the legs: rotations and stretching of the socks, turns to the left, then to the right, up and down with the feet of both legs.
Massage of feet and legs will be pleasant and useful.
Warm evening lemon balm foot baths can help. They will not only relieve unpleasant puffiness, but also relax and soothe.
It is necessary to wear comfortable shoes with low heels, preferably compression underwear (tights, stockings), which massages the skin and promotes the outflow of fluid.
Ventilate well at home or work. It should not be stuffy with high humidity.
Clothing should not be tight or squeezing the area of the lower extremities, so as not to increase the pressure that prevents the outflow of fluid.
If the gynecologist has appointed, you can drink special diuretic teas that help remove excess fluid. This can only be done on the recommendation of a doctor and in no case self-medicate. The expectant mother has a double responsibility: for herself and for the baby who is just about to be born.

If the legs during pregnancy swell in the ankles for natural reasons, after childbirth, in the vast majority of cases, the swelling goes away within a couple of weeks.

It is either an excessive accumulation of fluid in some particular part of the body, or the whole body is switching to excessive fluid retention. Inflammation, insect bite, trauma can lead to local edema. General edema is always a change in the state of the whole organism.

In order for edema to occur, two factors are necessary: the presence of fluid and tissue capable of retaining this fluid. In the summer, in the heat, a person always drinks more liquid, so there is no problem with it. Moreover, there are drinks that themselves strive to stay in the tissues - salty (mineral water) and sweet carbonated ("Buratino", "Bell", "Coca-Cola"). Under certain diseases and conditions, the body tends to store fluid. By the type of edema, assumptions are often made about the presence of this or that pathology in the body (edema suffers from "cores", "kidneys", diabetics, edema often manifests itself in women before menstruation), but especially often edema worries pregnant women and their doctors.

Pregnancy itself is a condition that promotes water retention in the body, and this is physiological. A person is 80% water, and in my mother’s body, "suddenly" in a relatively short time, a completely new organism is formed, for which water must be taken somewhere. During normal pregnancy, water is collected as much as 6-8 liters, 4-6 of which are outside the body tissues, and 2-3 - in the tissues. By the end of pregnancy, the baby, placenta and amniotic fluid accumulate about 3 liters of water. Another three liters are used to increase the mother's blood volume, to grow and enlarge the uterus and mammary glands. The volume of the liquid part of the blood begins to increase very early, p. It seems that the accumulation of fluid is of paramount importance, since the body begins to do this so early. And the truth: after all, how liquid and fluid the blood is, so quickly it will be able to deliver nutrients for the growth of the child, uterus, and mammary glands. And blood will be able to fill a whole new vascular system only when there is a lot of it.

However, not always all the liquid is only "used". Almost any biological system has excessive "greed" and tries to store up the necessary resource in case of its sudden disappearance. That is why edema is formed.

There are four degrees of severity of edema:

the first degree - the appearance of edema on the legs;
the second degree is swelling of the feet, legs, lower abdomen;
third degree - the occurrence of edema on the hands, the appearance of pasty face;
fourth degree - generalized edema (dropsy).

Most often, edema develops with. With gestosis, edema occurs after, in the morning, the legs become "cottony", shortness of breath, weakness and fatigue appear. Due to edema, a pregnant woman cannot stay on her feet for a long time, shoes become tight, rings cannot be removed or put on (ring symptom). When pressing on the lower leg, a fossa is formed, which does not disappear immediately. But edema does not always appear visually. Hidden edema is indicated by an increase in body weight of more than 300-400 g per week.

As already noted, edema is not always a pathology. At the end of pregnancy, the enlarged uterus presses on the inferior vena cava, which obstructs the outflow of blood from the veins of the lower extremities. In addition, the large uterus compresses the ureters, resulting in fluid retention. In women with varicose veins, when walking or standing for a long time, the feet and legs swell in the evening. Another type of physiological edema is constitutional. They occur in women with short stature and increased body weight.

The development of pathological edema is associated with a violation of water-salt metabolism, improper outflow of blood and lymph through the veins of the legs, increased permeability of the vascular wall and blood thickening. This mechanism of edema is inherent in gestosis (the old name is the second half of pregnancy), in which there is also an increase in blood pressure and proteinuria (protein in the urine). These symptoms are not always present as a complete triad, moreover, there are "dry" gestosis, when there is no edema at all, and they are considered a more severe case of the course of the disease.

How do you know if you have edema?

Answering a few questions will help. Have you been desperately pressing your favorite worn-out shoes lately? Does the wedding ring squeeze the finger, leaving a mark, with difficulty or not at all removed from the finger? Do the ribbed, long lasting marks of socks and socks leave a long lasting mark? Have you started to gain weight in excess of the norm (more than 300 g per week)?

Of course, not only the doctor will notice obvious edema, but also you. But there are also hidden edemas, or tissue pastiness (the so-called fluid retention in the body), which are not striking. They can only be suspected if the expectant mother has a large or uneven weight gain.

Most often, edema in healthy pregnant women who do not have cardiovascular or renal pathology appears in the second half of pregnancy. Usually, the legs swell first, then swelling of the hands, abdomen, and face may be added. The latter is especially upsetting for expectant mothers. After all, the eyelids swell most of all on the face. This is due to the anatomical features of this area. There is loose fiber, which, like a sponge, is ready to retain liquid.

In the morning, swelling on the legs is less noticeable, because at night the fluid evenly spreads throughout the body. But during the day, when you spend more time on your feet, the fluid goes down, accumulating mainly in the ankle area, on the back of the feet, on the lower legs, where finger pressure can cause a slowly flattening fossa. The skin with edema is pale, tense and smooth.

Simple home methods will allow you to understand if you have hidden edema, the presence of which must be reported to your doctor.

Weighing in dynamics

Excessive (more than 300 g per week) or uneven weight gain during pregnancy speaks of possible hidden edema.

Diuresis studies

Compare the amount of liquid drunk and urine excreted (per day). Normally, a healthy person excretes ¾ of the fluid they drink. For example, if you drank 1000-1200 ml of liquid per day (including soups and tea-coffee), at least 750-900 ml should be excreted in the urine. The remaining quarter of the fluid is excreted in the form of sweat and also during breathing. It is usually recommended to count diuresis for three days in a row in order to exclude a situation when a large amount of liquid was drunk on the eve of the start of the study, which was perfectly excreted on the first day of urine counting.

Measurement of leg circumference at one level in dynamics

An increase in the circumference of the ankle joint by 1 cm or more during the week indicates fluid retention in the body.

Western medicine considers edema during pregnancy to be a physiological phenomenon in the absence of an increase in pressure, protein in the urine and concomitant diseases. Russian doctors adhere to the point of view that edema during pregnancy is always the first signs of preeclampsia, which means that they must be treated. Unfortunately, it is impossible to accurately predict the course of pregnancy, especially the first one, so that a pregnant woman can meet both a doctor with a first and a second point of view, and most often the doctor's personal experience and the course of the observed pregnancies play a role here.

In any case, it is wise to engage in the prevention of edema.

Primary prevention is an examination of a pregnant woman in the early stages of pregnancy, a blood test for biochemistry and examination by specialists. In an early period, when there is still no edema and cannot be, it can already be assumed in which woman the development of pregnancy pathology is more likely. That is why there is so much talk about the need for early registration and early examination of pregnant women.

After determining the cause of edema, a natural question arises: how to deal with pathological edema (pregnant women)? First of all, you need to decide on a diet. Nutrition should be balanced and complete. Food should contain an increased amount of protein (meat, fish, chicken), since with gestosis there is a lack of it, which leads to an increase in vascular permeability.

We should not forget about carbohydrates - this is an energy material, in case of their lack, proteins will be consumed as energy. Fats are also needed for energy production and as a building material for the organs of the fetus. Fluid and salt restriction only aggravates the development of edema. Fluids per day should be at least 1.5 liters. But salty, pickled and spicy dishes are best avoided. You should limit the intake of sugary and carbonated drinks (Coca-Cola, lemonade): they lead to fluid retention in the body, creating a vicious circle of edema development.

Try to avoid prolonged standing or walking. In the morning, you need to raise your legs up (in a horizontal position). An energetic foot massage is effective. Kidney tea and other herbal teas should only be taken as directed by a physician. It is strictly forbidden to take diuretic drugs to treat edema caused by preeclampsia.

In, when a decently enlarged uterus presses on all organs of the abdominal cavity, including the kidneys and renal vessels, positional gymnastics helps well, and specifically the knee-elbow position for 1-1.5 hours a day. These 1.5 hours can be recruited with short "approaches to the projectile" of 10-15 minutes during the day.

If, despite prevention, the edema continues to grow, protein appears in the urine and the pressure crawls up, this is already a clinically pronounced preeclampsia, which is treated only in a hospital. In severe cases, the question of early delivery may arise, both in the interests of the mother and for the benefit of the child. Please do not refuse hospitalization.

Swelling during pregnancy is not uncommon. Almost every woman in the last weeks of gestation is faced with this problem, but the violation can be expressed to varying degrees. You also need to understand that the cause of edema can be different, sometimes this symptom is a sign of severe pathology that is dangerous for the life of the mother and child.

Causes of edema during pregnancy

Edema is a condition in which fluid accumulates in the body. This phenomenon can be observed locally, for example, with an injury or an insect bite, or throughout the body. As a rule, general edema is always associated with a pathological condition that affects the entire body of a woman.

Edema occurs when there is fluid in the body and tissue that retains water.

If a woman drinks a lot, for example, in the heat, then the likelihood of edema increases. Especially if the patient consumes drinks that retain fluid in the body, for example, salty mineral water, soft drinks, sweet fruit drinks and juices, as well as alcoholic beverages.

Edema can be a consequence of the pathology of internal organs. So, cardiac, renal edema is secreted, and a violation is also manifested in diabetes mellitus and hormonal failure in a woman. Pregnancy is a condition that in itself increases the likelihood of developing edema, and this is not always associated with a serious illness.

The fact is that for the correct development of the fetus, it is necessary to increase the supply of fluid in the woman's body. Some of the water is used for blood production to provide the fetus with nutrition. Several liters are needed to fill the fetal bladder with amniotic fluid. Also, water is needed to prepare the mammary glands for feeding the baby.

Thus, the amount of total fluid in the pregnant woman's body increases by about 8 liters by the end of the third trimester. And the body does not always successfully remove excess, therefore, water can accumulate in the tissues of the body and the formation of edema of varying degrees.

Pathological edema can occur for several reasons, the mechanism of the development of pathology is quite complex. The following diseases become the cause of general edema during pregnancy:

Heart pathology. In this case, the blood flow rate is disturbed, which leads to the release of fluid from the vessels into the surrounding tissues. Swelling takes a long time to form, they are quite dense, and concomitant cardiac symptoms are also observed. For example, shortness of breath at rest, palpitations, pale skin, chest pain, etc.
Kidney disease. In this case, the kidneys cannot cope with the flow of fluid, which leads to its accumulation in the body. Signs of renal edema: pale skin, swelling of the eyelids, poor appetite, protein in the urine, the swelling itself is mild and affects the entire body.
Hypertension. With increased pressure, the permeability of the vessels increases and the liquid enters the surrounding tissues, damage to the kidneys and urinary system occurs. As a result, the formation of edema. Usually, in this case, the legs and face swell first.

All these disorders in pregnant women can be combined into a condition called preeclampsia or late toxicosis, which forms in the third trimester. Gestosis is characterized by impaired cardiac, renal function, increased blood pressure and the formation of edema throughout the body.

Risk factors

Doctors identify a risk group whose women are more likely to suffer from edema and other manifestations of preeclampsia during pregnancy:

Delivery too early. If a girl becomes pregnant at the age of 15-17, the likelihood of developing preeclampsia increases greatly. Despite the established menstruation, at this age, puberty has not yet ended. An unstable hormonal background often leads to the development of complications during gestation.
Late childbirth. If a woman becomes pregnant after 35 years, then the likelihood of edema also increases. With age, the body wears out, organs function worse than at 20-25 years old, and the presence of various diseases in the anamnesis does not have the best effect.
Preeclampsia in a previous pregnancy. If a woman has a tendency to develop edema, then most likely the situation will repeat itself in subsequent pregnancies. Such women should be under strict medical supervision.
Severe toxicosis with persistent vomiting in the first half of pregnancy. It can be a consequence of pathology in the body, as well as the cause of impaired renal function.
Women who have worked or continue to work in hazardous industries.
Unfavorable living conditions, poor nutrition, smoking, alcohol consumption, a tendency to inflammatory and infectious diseases.
Multiple pregnancies. When carrying two children or more, the load on the body increases even more, the kidneys and heart may not be able to cope with it.

The likelihood of severe gestosis increases greatly if a woman has internal edema that was not detected in a timely manner.

Classification

First of all, it should be noted that edema is external and internal. External ones are visible with the naked eye: a woman's legs and arms swell, her face swells, and her stomach can also increase. Internal edema is not visible externally, which is very dangerous. Such a violation can only be identified by uneven weight gain.

In total, there are 4 degrees of external edema in pregnant women:

At the very beginning, the swelling appears only on the legs.
Legs and lower abdomen are affected.
The face and hands are swollen.
The whole body swells, dropsy may appear.

Most often, pregnant women experience grade 1-2 edema, which does not harm the fetus with timely treatment. Edema of the 3-4th degree is referred to as a serious condition that requires hospitalization, sometimes it is necessary to carry out emergency delivery - it all depends on the cause of this complication.

Gestosis in pregnant women can also be divided into 4 degrees:

The formation of dropsy is a local accumulation of fluid in the tissues.
Nephropathy is kidney damage.
Preeclampsia - accompanied by severe edema, high blood pressure, increased protein in the urine.
Eclampsia is the most severe form of gestosis, causing extremely serious complications, including pulmonary edema, placental abruption, fetal death, and renal failure in the mother.

In some cases, the pathology can develop very quickly, therefore, women with even the smallest edema should be regularly observed in the antenatal clinic and treated. If the condition worsens, immediate hospitalization is needed.

Signs of edema during pregnancy

It is not always easy to detect edema during pregnancy, therefore, a woman should be regularly observed at an antenatal clinic starting from 12 weeks. This is very important, since only with the help of weight control, urinalysis, ultrasound diagnostics can the process of the gestation period be accurately tracked.

legs began to swell in the evenings;
fingers on hands swell, rings become tight;
if you press on the skin with your finger, a white spot and a dent is formed;
a sharp increase in weight. Normally, a woman gains 300 grams per week. With edema, the weight can jump by 1-1.5 kg or more, although the woman did not change the diet.

Edema against the background of preeclampsia may be accompanied by headaches, increased drowsiness, nausea and vomiting, loss of appetite, increased uterine tone.

Diagnosis of edema is the prerogative of the gynecologist. The doctor prescribes a number of tests for a woman, in particular, urine and blood tests, measuring the volume of urine excreted per day, measuring blood pressure. All these procedures help to confirm the pathology and identify its causes.

Treatment of edema in pregnant women

Therapy for edema during pregnancy is carried out strictly under the supervision of a physician. There can be no question of any self-medication, this is indeed a very dangerous condition that can lead to the death of a child and the woman herself.

Treatment is usually medication. Prescribe drugs to lower blood pressure, diuretics, and a diet for edema. If the cause of the edema is, for example, inflammatory kidney disease (pyelonephritis), then a course of antibiotics and anti-inflammatory drugs may be prescribed.

The diet for edema will be different, depending on the cause of their development.

With gestosis, a balanced diet with an increased amount of protein is prescribed. In case of impaired renal function, for example, against a background of inflammation, protein from the diet is removed in the first few days of treatment to make it easier for the kidneys to work. Then protein food is gradually introduced in a small amount.

It is also necessary to observe the drinking regime. It is very important to drink enough liquid, at least 1.5 liters, but not to overdo it. Lack of water, as well as excess, leads to disruption of the vascular system and the formation of edema.

The same thing happens with salt. The complete exclusion of salt threatens to disrupt the function of the endothelium (a layer in the blood vessels), which is responsible for vascular tone. Violation of contractility leads to an increase in capillary permeability and edema.

Excessive salt intake is also negative, because sodium chloride tends to retain fluid in the body. Therefore, salt is not completely excluded, but its amount is reduced to 3-3.5 grams per day.

As you can see, the diet for edema can be different, so you do not need to limit yourself too much on your own. It is enough to exclude from the diet very salty, spicy, sweet, fatty. It is better to drink just purified water without gas, and steam, bake and boil food. It is very important that food is fractional, 5-6 times a day in small portions, so that it is easier for the body to cope.

fresh cranberries, cranberry juice and juice;
lingonberry juice, lingonberry leaf decoction;
watermelons;
cucumbers;
fresh pumpkin juice;
grapefruit, etc.

You can also alleviate your condition with the help of physical activity. Exercise for pregnant women from edema helps to improve blood circulation and fluid flow. Swimming is one of the most beneficial physical activities. Daily walks are also useful, but not too long, about 30-60 minutes a day, optimally - 30 minutes in the morning and in the evening.

At home, you can do a simple and effective exercise. You need to get on all fours and alternately smoothly pull one leg to the stomach, then straighten it back, repeat 5 times. Return to starting position and exercise on the other leg.

Prevention of edema during pregnancy

To prevent swelling during pregnancy, you must:

take a responsible approach to planning pregnancy, undergo a course of treatment for diseases if necessary;
it is desirable to become pregnant between the ages of 20 and 30;
be in a comfortable environment, live in a dry, warm room, dress in clean clothes;
adjust nutrition - it should be healthy, balanced;
avoid a passive lifestyle, but do not abuse physical activity;
be regularly examined in the antenatal clinic, take vitamins as needed and follow the doctor's recommendations.

Most often, edema with gestosis in pregnant women in the third trimester is associated with a hereditary predisposition, which is difficult to deal with. A woman can reduce the risk of complications if she adheres to preventive measures and is examined. Timely detection of edema will help to take timely measures to eliminate them and prevent premature birth and other complications.