Swelling in pregnancy is not unusual because of the normal changes in your body that occur when you are pregnant. However, moderate to severe swelling or a sudden increase in swelling can be a sign of medical problems, which could put you and your baby at risk for complications.
Overview of Swelling
Like many women, you may notice swelling or edema in pregnancy, especially as you advance to the third trimester. A small amount of swelling is expected and will resolve soon after you deliver your baby.
Locations
Your feet, ankles, legs, hands, wrists, and face are the most common areas to swell, and your rings and shoes might get tight. Less commonly, you may have swelling in your labia.
The edema is likely to get worse from standing or sitting all day, especially in your feet and ankles, and improve overnight from lying down.
The Main Causes
There are three main causes of swelling in pregnancy:
- The normal increase in body fluids: When you get pregnant, your circulating blood volume and total body water increase. Excess fluids can leak out of your blood vessels into your tissues and cause you to swell.
- Increase in sodium: An increase in sodium in your blood causes you to retain more water.
- The growing uterus: As your uterus grows, it presses on the veins in your belly and interferes with the return of fluid to your heàrt. This causes swelling, mostly in your feet.
Eating a lot of salty, processed food can also make you retain more water and increase the chance of swelling in pregnancy.
Secondary Medical Causes
Moderate to severe or persistent swelling in pregnancy can be caused by medical problems.
Preeclampsia
One of the most serious complications of pregnancy associated with edema is preeclampsia. You may have preeclampsia if your blood pressure is high and you notice:
- A sudden increase in your swelling, puffy face, and eyelids
- Sudden weight gain of more than two pounds in 24 hours
You may also have headaches and changes in your vision and notice a decrease in your urine output.
Other Medical Causes
Other medical problems associated with swelling in pregnancy include:
- Diabetes, because of leaky capillaries, which cause fluid to leak into tissues
- Kidney disease with decreased urine output
- Damaged veins in your legs (venous insufficiency) which decreases blood flow back to your heart
- Blood clots in your in lower extremity, usually involving one leg
- Underlying heart disease such that your heart can't handle the excess fluids in your body
- Low protein in your diet increases fluids in your tissues
- An allergic reaction to food or medicines
What to Do
Take the following steps to decrease fluid retention and swelling:
- Drink enough fluids throughout the day, as this will help you to urinate off some of your excess body fluids.
- Limit processed, salty foods in your diet.
- Eat enough protein as recommended.
- Elevate your feet above your waist whenever you can during the day and at night.
- Sleep on your left side to shift your uterus off the big vein in your abdomen. A pregnancy pillow can help you maintain this position.
- Exercise, such as walking, can improve your circulation and help you mobilize fluid from your tissues. Check with your doctor for safe exercises.
- Light flotation exercises in an immersion pool can increase urine output and reduce swelling but check with your doctor first.
In addition, remove your rings as soon as they begin to get tight before they become difficult to remove and avoid wearing tight shoes.
Consult Your Doctor
Some swelling is expected in pregnancy and is not usually of major concern. Talk to your doctor if you have more than mild swelling or notice a sudden weight gain, especially if you have other symptoms that suggest preeclampsia or other medical problems.
