From the Guidelines
Leg swelling during pregnancy is a common and typically normal occurrence, but it's crucial to monitor and manage it to prevent complications like deep vein thrombosis or preeclampsia, which can significantly impact morbidity, mortality, and quality of life. To manage pregnancy-related leg swelling, elevate your legs whenever possible, avoid standing for long periods, wear compression stockings, stay physically active with gentle exercises like walking or swimming, and maintain adequate hydration while limiting salt intake 1. When resting, lie on your left side to improve circulation. Avoid tight clothing around your legs and ankles, and consider wearing supportive, comfortable shoes. This swelling (edema) occurs because your body produces more blood and fluid during pregnancy to support your baby, while the growing uterus puts pressure on your veins, slowing blood return from your legs to your heart.
Some key points to consider:
- Leg swelling is a frequent finding in pregnancy, and it's essential to differentiate between normal swelling and signs of more serious conditions like deep vein thrombosis or preeclampsia 1.
- The risk of venous thromboembolism (VTE) is increased during pregnancy, especially in the postpartum period, and it's essential to assess individual risk factors and provide prophylaxis when necessary 1.
- Pregnancy leads to hypercoagulability, stasis, and vascular injury, which can increase the risk of thrombosis, and it's crucial to monitor and manage these risks to prevent complications 1.
- While usually harmless, contact your healthcare provider if you experience sudden or severe swelling, especially if it's one-sided or accompanied by pain, headaches, vision changes, or upper abdominal pain, as these could indicate more serious conditions like deep vein thrombosis or preeclampsia 1.
Given the potential risks and complications associated with leg swelling during pregnancy, it's essential to prioritize monitoring and management to prevent adverse outcomes and ensure the best possible quality of life for both the mother and the baby.
From the Research
Causes of Leg Swelling in Pregnancy
- Leg swelling in pregnancy can be caused by various factors, including pregravidity episodes of venous conditions (vascular insufficiency and thrombosis) and the lack of physical exercise during pregnancy 2
- There is no significant link between the occurrence of edema and the number of times a female had been pregnant, physical activity before gravidity, or body mass index before gravidity 2
Prevention and Treatment of Leg Swelling
- Compression therapy in combination with proper physical exercises appears to be an effective means to prevent and treat venous thrombosis and lower limb edema in pregnant women 2
- Walking with compression bandages or medical compression stockings can help reduce pain and swelling in patients with acute proximal deep venous thrombosis 3
- Early ambulation with heavy leg compression can help reduce the risk of pulmonary emboli in patients with symptomatic acute leg deep venous thrombosis 4
Comparison of Compression Methods
- Intermittent pneumatic compression (IPC) and graduated compression stockings (GCS) are both effective for deep vein thrombosis prophylaxis, but IPC may have a lower DVT rate 5
- The choice between IPC and GCS should be based on individual patient needs and clinical circumstances, as there is only weak evidence to show a difference in performance between the devices 5