Differential Diagnosis for New Leg Swelling in Pregnancy
- Single Most Likely Diagnosis
- Venous Insufficiency or Varicose Veins: This condition is common in pregnancy due to increased blood volume, venous pressure, and the relaxing effect of progesterone on smooth muscle, leading to venodilation and increased venous stasis.
- Other Likely Diagnoses
- Deep Vein Thrombosis (DVT): Pregnancy increases the risk of DVT due to hypercoagulability, venous stasis, and vascular wall injury. Symptoms can include leg swelling, pain, and warmth.
- Cellulitis: A bacterial infection of the skin and subcutaneous tissue, which can cause swelling, redness, warmth, and pain in the affected leg.
- Lymphedema: Although less common, lymphedema can occur in pregnancy, especially if there's a history of lymph node removal or infection.
- Do Not Miss Diagnoses
- Pulmonary Embolism (PE): A potentially life-threatening condition that can occur in conjunction with DVT. Symptoms might not be limited to the leg and can include shortness of breath, chest pain, and cough.
- Phlegmasia Cerulea Dolens: A severe form of DVT that causes significant swelling and cyanosis of the leg, which is a medical emergency.
- Compartment Syndrome: Increased pressure within a muscle compartment can lead to severe pain, swelling, and potentially permanent damage if not promptly treated.
- Rare Diagnoses
- Lipedema: A chronic condition characterized by the abnormal growth of fat cells in the legs, leading to swelling and pain, which can be exacerbated by pregnancy.
- Sarcoma or Other Soft Tissue Tumors: Although extremely rare, these conditions can cause leg swelling and should be considered if other diagnoses are ruled out and symptoms persist or worsen.