Swelling of the legs when sitting
Four out of five women during pregnancyface such an unpleasant symptom, as swelling of the legs. They can have different severity - from a barely noticeable increase in the volume of the ankles in the evening to a strong edema of the feet, shins, thighs, and in severe cases - and the entire body. Edema in pregnant women always cause concern to a woman and a doctor. They can be a variant of the norm, but in some cases are a sign of serious complications.
Most often, edema in pregnant women appears, starting with the second trimester. Most strongly they appear at the end of pregnancy, and in some cases persist even after birth, gradually disappearing.
Most often, swelling during pregnancy is caused by physiological mechanisms:
In addition, the cause of edema can be a complication of pregnancy, like gestosis.
Cardiovascular or renal diseases that existed in the patient prior to pregnancy can lead to decompensation of cardiac or renal failure, which is also accompanied by swelling.
Physiological swelling in pregnancy
Increase in the concentration of progesteronepregnancy is a physiological mechanism aimed at its preservation. One of the additional effects of progesterone is a delay in the kidneys of potassium and sodium. These ions "pull" the water back to the vascular bed, that is, the reabsorption of water and salts in the kidney canals increases. The increasing volume of fluid is distributed unevenly in the body, part of the water penetrates into the intercellular space, where it forms edema.
The physiological edemas descend under the action of gravity. Therefore, they arise, for example, in the area of feet and ankles after long walks in the evening.
Increased during pregnancy, the uterus squeezeslarge venous trunks, draining blood from the lower extremities. This condition is called the syndrome of the inferior vena cava and is manifested by syncope in the position of a woman lying on her back. The enlarged uterus squeezes the way of venous and lymphatic fluid outflow from the lower limbs. As a result, venous congestion occurs in the enlarged and crowded veins. There are swelling.
Liquid retention can also occur due todecrease the filtration function of the kidneys because of the pressure on them of the enlarged uterus. A certain role in the appearance of edema is played by the behavior of a woman, that is, the amount of liquid consumed by her. If the amount of liquid drunk and the ability of the kidneys to mismatch the excess of water accumulate in the body.
Edema as a manifestation of gestosis
Swelling of the feet can be one of the first manifestationscomplications of pregnancy - gestosis. In addition, the signs of this serious condition are arterial hypertension and the appearance of protein in the urine. Under these conditions, the exchange of water and salts is disturbed, the permeability of small vessels - capillaries - is increased, the liquid part of the blood swims through the walls of blood vessels into the intercellular space.
In this case, the fluid accumulates in the tissuesthe placenta, causing oxygen starvation of the fetus. Cerebral edema leads to visual disturbances and seizures. In the case of severe gestosis, preeclampsia and eclampsia develop. In case of untimely medical care, a woman and a child may die under these conditions.
It should immediately consult a doctor if swelling on the legs is accompanied by an increase in blood pressure above 140/90 mm Hg. headache, nausea, impaired consciousness or convulsions.
Edema as a sign of heart failure
Virtually any cardiologic disease,which the woman suffered before pregnancy, during this period is more difficult. In particular, the probability of developing a "universal" complication of cardiac diseases - heart failure is high.
Edema is a manifestation of right ventricularheart failure. They are a consequence of a decrease in the pump function of the heart as a result of pulmonary hypertension, pulmonary artery valve defects or tricuspid valve. At the same time venous blood is pumped through the heart with insufficient speed, therefore it accumulates in the veins of a great circle of blood circulation. One of the important signs that make it possible to distinguish "cardiac" edema from others is the enlargement of the liver. It is accompanied by heaviness, aching pain in the right hypochondrium, sometimes a feeling of bitterness in the mouth and eructation. The liver during palpation is defined below the edge of the costal arch, it is smooth, elastic, slightly painful.
In some cases, edema is accompanied by signsleft ventricular failure and pulmonary hypertension - weakness, shortness of breath with minimal load and lying down, dry cough at night, sometimes even with an admixture of veins of reddish sputum or foam.
If a woman has swelling and listed signs of heart failure, she needs to urgently go to the doctor, go through an ultrasound examination of the heart, adjust the treatment.
Edema in kidney disease
The most common causes of "kidney" edema -chronic glomerulonephritis and other diseases accompanied by nephrotic syndrome. A sign that allows one to suspect this cause of the development of edematous syndrome is the puffiness of the face and especially the eyelids in the morning.
In this case, seek medical attention. Progression of kidney failure may threaten the health and life of the mother and child.
There are several ways to determine whether a pregnant woman has swelling and whether they are growing.
The simplest signs are the impossibility of putting onshoes for the evening or difficulty when removing from the finger of the wedding ring. Helps to see the fluid retention and the track from the elasticity of socks on the ankle, fluctuations in the size of the ankle circumference over 1 cm per day.
On the presence of edema, including internal, indicates a rapid or uneven weight gain: more than 300 - 400 grams per week.
To more accurately determine the balance betweendrunk and allocated liquid is recommended to keep a drinking diary. The column "drunk" takes into account all the liquid consumed per day, including drinks, soups, fruits and vegetables. One average fruit is taken equal to 50 grams of water.
During the day, you need to collect all the extracted urine in one container, and then determine its volume.
Then the amount of liquid drunk in milliliters should be multiplied by 0.75 and thus the normal volume of the extracted liquid in milliliters is obtained. If in fact it is less - there are swelling.
Treatment of edema during pregnancy
Edemas during pregnancy require constant attention of the doctor, so as not to miss the development of gestosis and other complications.
With physiological edema is enoughuse less salt and spices, chocolate, caffeine, fatty and fried foods. The fluid is better not to limit. However, a decrease in salt intake will help to reduce the amount of water that is drunk, respectively, in a physiological manner. It is generally advisable to give up salt or reduce its intake to 5 grams (one teaspoon) in knocking. In the dish you do not need to dosalivat.
A rational organization of activity andrecreation. A pregnant woman should walk more, but staying on her legs should alternate with rest. You can sit down on a bench every half an hour, take off your shoes and lift your legs on the seat, covering them with a light napkin. In the winter season, walks can be shortened in time, but more frequent.
Lie on your back with your legs up, notit is recommended, because at the same time the lower hollow vein is compressed, which further disturbs the venous outflow. A woman should take a position half-sitting or even lying on her side. It is especially convenient to use for this purpose special pillows for pregnant women, allowing you to lean on your back and raise your legs.
After consulting a doctor, it may take some timetake diuretics, in particular, plant (kanefron). It should be remembered that furosemide can be taken only a short course, hypothiazide during pregnancy is better not to use, and veroshpiron is contraindicated.
Video about swelling during pregnancy: