Swelling of the legs in the last stages of pregnancy
Last reviewed: 23.04.2024
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Swelling of the legs is more typical for late pregnancy. Some swelling may be the result of compression of the inferior vena cava with an enlarged uterus in the prone position, a violation of outflow from both femoral veins. Leg edema can also be the result of deep vein thrombosis, which develops during pregnancy often. There is a state of hypercoagulability, a woman becomes less mobile. Leg edema can be the result of pre-eclampsia, as well as hypertension associated with pregnancy.
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Diagnostics of the swelling of the legs in the last stages of pregnancy
Diagnosis of leg edema in the last stages of pregnancy
For diagnosis, deep vein thrombosis and pre-eclampsia should be excluded. It is necessary to carry out differential diagnostics with physiological edema.
Anamnesis. The common risk factors for deep vein thrombosis are venous insufficiency, trauma, existing hypercoagulable disorder, cigarette smoking, immobility and cancer. Common risk factors for preeclampsia are chronic arterial hypertension, personal or family history of pre-eclampsia, age below 20 years, first pregnancy, multiple pregnancies, diabetes, vascular disorders and bladder arthritis. With unilateral edema, deep vein thrombosis can be suspected. Acute dyspnea may develop with pulmonary embolism due to deep vein thrombosis. If there is swelling of the face or hands (for example, if the ring no longer fits the size of the finger), you can suspect pre-eclampsia. And also the symptoms on which it is possible to suspect pre-eclampsia are: headache, epigastric pain, other central or peripheral neurologic disorders, visual impairment and a tendency to bleeding.
Clinical examination. Blood pressure is measured; Arterial hypertension (BP> 140/90 mm Hg) is characteristic for preeclampsia. Changes in the fundus, diffuse hyperreflexia, jaundice, petechiae and purpura may also indicate preeclampsia. Unilateral reddening of the foot, warming and soreness suggest deep vein thrombosis.
Laboratory diagnostics. If suspected of pre-eclampsia, the protein in the urine is determined. Conduct a test determination of protein in the urine, but if the diagnosis is unclear, then determine the level of protein in the daily urine. Arterial hypertension and proteinuria indicate preeclampsia. Other tests are performed based on suspected clinical disorders.
Treatment of the swelling of the legs in the last stages of pregnancy
Treatment of edema of the legs in the last stages of pregnancy
The physiological edema of the legs can be reduced with the periodic lying position on the left side, as a result of which the pressure of the enlarged uterus on the lower hollow vein decreases. Elastic medical stockings are also used.