Every woman experiences weight gain during pregnancy, which may range from 7 to 18 kilograms depending on pre-pregnancy body weight. Underweight women gain more and the opposite is true for overweight women.

But, what causes this weight gain during pregnancy? The baby and your growing body to accommodate it? Of course.

Though, some amount of weight gain in the body is also due to an increase in body fluids and their retention. This may lead to the appearance of swelling, which is quite common in pregnant women with 8 in 10 women experiencing oedema during some stage of pregnancy. However, swelling may be a matter of concern in some, wherein it is an indicator of the risk of preeclampsia.

Read this article to know all about pregnancy swelling, its types and when and why does swelling occur. Further, know some tips to aid relief from swelling and understand when it can be a warning sign for your health. This article has a special section for feet swelling during pregnancy.

  1. Oedema during pregnancy
  2. Symptoms of oedema during pregnancy
  3. When and why does swelling occur during pregnancy
  4. How does swelling occur during pregnancy
  5. Face and hand swelling during pregnancy
  6. Feet swelling during pregnancy

During pregnancy, the body produces 50% more blood and body fluids in order to support the needs of the developing baby. This is one of the major causes of swelling in the body.

Swelling during pregnancy is primarily seen in the face, hands, legs, ankle and feet with feet being the most common site. Other than this, a generalised swelling of the body also occurs during pregnancy.

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During pregnancy, you may note the classic signs of oedema or swelling, which are:

  • Feet start to look swollen and feel heavy. Other areas like the hands and face are not visibly swollen but do feel heavy.
  • Your footwear starts to feel discomforting.
  • Jewellery, particularly your rings start to feel tight.
  • A slight rise in temperature in the area of swelling (not necessary).
  • Restriction in the movement of the swollen area.
  •  A heavy feeling due to a generalised swelling of the body.
  • Sometimes, pain may also be experienced.

These signs and symptoms are completely physiological to an extent and is experienced by most pregnant women. However, an excessive swelling can be a sign of preeclampsia, which will be discussed in the later sections.

Due to the potential health risks of this condition, it is recommended that you see a doctor in case of severe feet swelling or the presence of other discomforting symptoms.

(Consult physician online)

Swelling is more common during the later stages of pregnancy, that is, during the third trimester. As pregnancy progresses, the size of the foetus grows, which means that it requires more space to accommodate within your body. So, your body progressively increases in size to provide sufficient room for the foetus.

Generalised swelling of the body is important for supporting this process of body growth. Extra retention of fluid softens body tissues during pregnancy, which will allow them to expand faster. Extra fluid around the pelvic area is further essential during the later stages of pregnancy as it prepares your body for delivery.

Moreover, the foetus rapidly grows in size during the third trimester since major organ formation has already occurred. To achieve this, your body requires to grow faster and thus more swelling is seen in these stages.

Swelling during pregnancy primarily occurs due to water retention. During pregnancy, the total amount of body water increases up to 6 to 8 litres, out of which, 4 to 6 litres is extracellular and is a cause of the swelling. Sodium retention is another cause of water retention and swelling.

Other than this, hormonal changes during pregnancy cause changes in the vascular function. Impaired functioning of veins prevents blood flow from the feet to reach back to the heart, in other terms, reduces venous return. This is the major cause of oedematous feet evident during pregnancy.

While leg swelling may be most commonly experienced during pregnancy, some women also experience swelling in the face, hands and fingers. It is often less evident than feet swelling and is often apparent as a slight tightening of jewellery and rings. In the face, mild swelling may be seen around the area of the eyes, which is also called as corneal oedema.

However, if the swelling in these areas is more pronounced and visible, it is often indicative of an underlying problem.

Severely swollen fingers may be due to excessive sodium and water retention. Face swelling, however, may be of a bigger concern and could be a sign of a hypersensitive reaction, particularly if it is accompanied by itching.

Doctors have reported the case of a 33-year-old pregnant woman who presented with progressively growing facial swelling and scalp itching due to an allergic reaction to hair dyes. You may like to know that hair dyes contain a chemical, paraphenylenediamine, which is a potential allergen and can cause contact dermatitis. So, you must be careful before using any hair products during pregnancy to avoid allergies.

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Swollen feet are a common symptom of the third trimester of pregnancy, but may begin in the 6th month. Although they are noted in most women, the following factors increase the risk of swollen feet:

  • Prolonged standing 
  • Low levels of physical activity
  • A diet high in sodium or low in potassium
  • Excessive consumption of salt
  • High caffeine consumption
  • High environmental temperature
  • Uncomfortable footwear

How to reduce swelling in legs during pregnancy

Swelling during pregnancy does not pose a health risk but may be immensely discomforting, which is why you may like to prevent it or reduce it once occurred. Following measures can help to manage feet and leg swelling:

  • Avoiding standing still for a prolonged duration. This will help in avoiding swelling by reducing physical exertion and will also reduce the pressure on veins allowing them to function normally.
  • Raise the level of your feet to aid venous return. While sitting, you can prevent your feet from hanging down directly and while sleeping, it is recommended to place a pillow to raise the level of your feet. This will help in the backflow of blood to the heart thereby reducing swelling.
  • Always wear comfortable shoes during pregnancy in order to avoid your feet from swelling. Avoid heels and any other footwear with tight straps that can affect the vascular functioning.
  • Wear loose clothing. Avoid wearing anything that restricts blood flow to your feet.
  • Avoid going out when the weather is too hot.
  • Wear supportive tights or stockings to manage swelling.
  • Limit your salt consumption since it leads to water retention. Do not sprinkle additional table salt to food items and stay away from cheese, pickles, chips and processed foods.
  • Increase your water intake. This will help to flush off excess sodium and other waste products from your body minimising water retention.
  • Exercise regularly but do not exert yourself. Exercise is important to maintain adequate blood flow to the feet and it also helps in maintaining proper vascular functioning. At the same time, it is important to avoid exertion since this may worsen swelling.
  • Other than this, limiting the consumption of caffeinated beverages including tea, coffee and energy drinks is likely to help.
  • Cold compress and elevation will provide some relief.

Exercises to reduce feet swelling during pregnancy

It is inadvisable to stand for long periods or perform intense exercises during pregnancy as this could worsen your feet swelling. Taking regular walks during the day and certain foot exercises will help you manage the swelling. Here are some simple exercises you can do at home:

Stretching:

  • Sit comfortably and bend your feet
  • Now, stretch your foot up and down 30 times
  • Perform this exercise daily or whenever you feel any discomfort because of the swelling

Rotation:

  • Sit down and stretch your leg
  • Now, bend your feet and try to perform a rotation
  • Perform 8 reps clockwise
  • Repeat the same exercise while performing the rotation anticlockwise
  • Perform daily or whenever the need be.

The above exercises are beneficial in reducing foot swelling. They improve the blood circulation to the feet and help in improving the vascular functioning of the area, which alleviates oedema. Other than this, exercising your leg helps to avoid muscular cramps in the calf area.

If you are comfortable, you can also perform this exercise while standing. But, if you experience intense pain while performing these exercises, it is recommended to stop immediately and consult your doctor.

Swollen legs and the risk of preeclampsia

Swollen legs can be indicative of an underlying pathology, particularly when accompanied by other conditions like hypertension. Gestational hypertension, if left untreated, can pose a serious threat to both the mother and the child. It is a major cause of hospitalisation during pregnancy and can even cause problems during the normal delivery of the baby. Elevated blood pressure and excessive swelling in legs is often a sign of preeclampsia, which must not be ignored. Other symptoms of this condition are proteinuria or the presence of protein in the urine, which can be detected with the help of a urine test. So, if your legs and feet are extremely swollen, it is important to undergo these diagnostic tests.

It is important to note that the risk of preeclampsia is higher during first-time mothers. This risk is the highest during the third trimester of pregnancy, but can even occur earlier as and when the swelling in feet is noted.

The severity of the condition is determined by the rise in blood pressure. A slight increase in blood pressure and the elimination of some amount of protein occurs with the urine in mild cases. Improvement in symptoms and reduction in blood pressure and swelling occurs after the birth of the baby and retrieval of the placenta in these cases.

However, if your blood pressure is too high, preeclampsia is severe and it cannot be left untreated. Severely high blood pressure can result in preterm delivery, low birth weight and can also be a cause of fatality in the mother because of the risk of stroke. It can also interfere with the functioning of the major organs of your body including the kidney, liver and the brain.

Further, it can lead to growth restriction of the foetus due to the poor blood supply and can also cause placental abruption, wherein the placenta separates itself from the uterine wall.

Following are the signs and symptoms of this condition:

In case you observe any of these symptoms, it is important that you see your doctor and get yourself tested. If untreated, it can cause the following problems in addition to the harmful effects on the foetus, which have been discussed.

How can you avoid these risks?

You can avoid complications due to swelling during pregnancy by:

  • Taking proper prenatal care.
  • Visiting your doctor for regular checkups.
  • Indulging in regular physical activities to prevent swelling and to keep blood pressure in check.
  • Monitoring blood pressure closely during the course of your pregnancy.
  • Taking abnormal swellings seriously and seeking medical help.
  • Taking prescribed medications on time, especially if you have high blood pressure.
  • Not ignoring any symptoms.

References

  1. Davison JM. Edema in pregnancy. Kidney Int Suppl. 1997 Jun;59:S90-6. PMID: 9185112
  2. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Causes and signs of edema. 2008 Nov 5 [Updated 2016 Dec 30].
  3. Michel E van Genderen. Severe facial swelling in a pregnant woman after using hair dye . BMJ Case Rep. 2014; 2014: bcr2013202562. PMID: 24686800
  4. American Pregnancy Association. [Internet]; Swelling During Pregnancy.
  5. Better health channel. Department of Health and Human Services [internet]. State government of Victoria; Pregnancy - pre-eclampsia
  6. Center for Disease Control and Prevention [internet], Atlanta (GA): US Department of Health and Human Services; High Blood Pressure During Pregnancy
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