Mom-to-be worried about swollen feet in pregnancy

All Woman

Dear Dr Mitchell,
I am pregnant and my feet are extremely swollen, even if I'm not walking around a lot. My doctor doesn't seem to be concerned, and only encourages me to elevate them. But could this be a sign of something being wrong with me, or the baby? I just want everything to go smoothly. I am 27 weeks along.

Swollen feet are common in pregnancy and are seen in as much as 80 per cent of pregnant women. The problem tends to become pronounced as the pregnancy gets more advanced. It is usually as a result of the compression of the vessels in the lower limbs by the enlarging uterus and foetus. This can sometimes be associated with elevated blood pressure and the passage of protein in the urine. In this case the condition is called pre-eclampsia. This has to be taken seriously and managed very closely since it can cause complications in both the mother and the foetus. In severe cases this can progress to the development of seizures in the pregnancy.

The retention of fluid and swelling of the feet and legs may also be associated with a significant increase in weight gain in the pregnancy. Other associated symptoms include headaches, blurred vision, and pain in the abdomen, especially upper part of the abdomen in the region of the stomach and liver. These symptoms are usually an indication of severe pre-eclampsia and need to be dealt with urgently.

It is important that you see your doctor more frequently and get your blood pressure checked regularly, in addition to checking for protein in the urine. This will pick up early signs of pre-eclampsia so that close monitoring of the mother and the foetus can be done. In severe cases, treatment with blood pressure medication is necessary to reduce the risk of complications in the pregnancy to the mother and baby. The use of steroids to mature the foetal lungs is usually necessary if delivery has to be done before 34 weeks gestation. Medications to prevent seizures in the pregnancy is necessary in severe cases.

If your blood pressure and urine tests are both normal, then elevation of the legs on a soft cushion will help to relieve some of the discomfort in the feet and legs when you are resting. It is important to still move around since prolonged bed rest without the use of blood thinners to prevent the formation of a clot in the legs is extremely dangerous.

The problem will not go away until after delivery of the baby. In the first few days after delivery it might even worsen and then start to improve thereafter.

Consult your doctor who will follow you up closely to ensure that any evidence of pre-eclampsia is detected early and managed appropriately. In the meantime, buy some comfortable shoes that are flat and at least one size bigger than your regular size, and with wide width. Intermittent elevation of the legs will help in the short term.

Wishing for you and your baby a safe pregnancy and a perfect outcome with the delivery.

Best regards.

Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver.com; write to All Woman, 40-42 1/2 Beechwood Avenue, Kingston 5; or fax to 876-968-2025. All responses are published. Dr Mitchell cannot provide personal responses.

DISCLAIMER:

The contents of this article are for informational purposes only, and must not be relied upon as an alternative to medical advice or treatment from your own doctor.

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