MOST women will experience moderate amounts of swelling in the ankles and feet, especially in the third trimester of pregnancy. And this is quite normal; however, medical internist Dr Samantha Nicholson-Spence says there are times when swelling may indicate that there is a more serious underlying condition.
“The truth is swelling on its own looks way more serious than it really is and the most that will happen is that you may feel some amount of discomfort. There are instances, however, when your swelling may be linked to some serious and even life-threatening conditions such as pre-eclampsia or deep vein thrombosis,” Dr Nicholson-Spence said.
She pointed out that a pregnant woman should contact her obstetrician-gynaecologist or her primary care physician immediately if she notices symptoms such as swollen hands or face, when swelling is more than that usually experienced, or when swelling is noticed at the start of the day or doesn't go down when you rest or even elevate the legs. These are warning signs of pre-eclampsia.
“Pre-eclampsia is a condition characterised by high blood pressure and protein in the urine. The condition, which is potentially life-threatening for both mom and child, especially without proper medical care, is most commonly seen in women who are in their third trimester of pregnancy,” Dr Nicholson-Spence outlined.
She said that other symptoms that may suggest that a pregnant woman is suffering from pre-eclampsia are sudden swelling in the hands and feet, face, headaches, blurry vision and upper abdominal pain.
Some possible complications that may occur in patients with pre-eclampsia include eclampsia, a life-threatening condition that leads to seizures in mothers, and HELLP Syndrome (haemolysis, elevated liver enzymes, and low platelet count). This life-threatening condition is marked by liver dysfunction and it affects the way the blood clots as well as breaks down red blood cells. In the baby, since this can also impede the flow of oxygen and food to the baby, this may result in low birth weight.
Another possible culprit of swelling in the lower extremities during pregnancy is deep vein thrombosis. Dr Nicholson-Spence said that a hallmark of this condition is when one leg is more swollen than the other.
“Deep vein thrombosis is a condition that occurs when a blood clot develops deep in the leg, but on less frequent occasions the thigh or pelvis. While not common in pregnancy, pregnant women are more prone to this condition than non-pregnant women because of an increase in the level of blood-clotting proteins during pregnancy while the anti-clotting protein levels decrease,” Dr Nicholson-Spence explained.
She said that women should have leg pain and swelling that persists even after sitting/resting for several hours investigated as this may indicate deep vein thrombosis. Medical care should also be sought if any of these symptoms are accompanied by pain or tenderness in your calf or thigh because this may be a sign of a blood clot.
Another red flag of swelling in the feet during pregnancy is when this is accompanied by pain while taking deep breaths, you experience fast breathing, you sense an increase in your pulse, or a persistent cough. Dr Nicholson-Spence said this could be a sign of pulmonary embolism. This condition is life-threatening and occurs when you have passed a blood clot to your lung.
Dr Nicholson-Spence reiterates that most times swelling during pregnancy is nothing to worry about and most women will experience some amount of swelling. Most times swelling will be relieved by good posture, cutting back on sodium and processed foods, increasing your consumption of potassium-rich fruits and vegetables, remaining physically active (even if this is minimal), propping your feet up so they're higher than your heart when you are sitting, wearing compression stockings, getting regular massages, staying cool, and resting.
She warned, however, that if you're concerned that your swelling is not normal, then you should contact your primary care physician or head to the hospital to ensure your and your baby's safety.