What diseases should be differentiated from renal edema in pregnant women?

The most feared thing after pregnancy is suffering from a serious disease. Renal edema in pregnant women is not common. In the early stages of the disease, pregnant women will have edema in the lower limbs, and the swelling is very severe, accompanied by abnormal urination and urine. Pregnant women can find out about kidney problems by going to the hospital for a check-up, and the type of disease can be accurately determined. It is necessary to differentiate it from diseases with similar symptoms. So what diseases should be differentiated from renal edema in pregnant women? The diseases that need to be differentiated are:

(1) Cardiogenic edema:

In case of right heart failure, exudative or constrictive pericarditis, edema is caused by increased venous pressure in the systemic circulation and increased capillary filtration pressure. The characteristic of cardiogenic edema is that it first occurs in the lower part of the body, often gradually spreading from the lower limbs to the whole body. In severe cases, ascites or pleural effusion may occur. Edema forms slowly. The edema is firm in nature and less mobile. The diagnosis of cardiogenic edema is based primarily on the history and physical signs of heart disease. A significant increase in venous pressure is an important adjunct to diagnosis.

(2) Hepatic edema:

Before ascites appears in cirrhosis, there is often mild edema in the lower limbs, which first occurs in the ankles and gradually spreads upward. There is usually no edema in the head, face, and upper limbs. In severe cases, ascites and pleural effusion may occur. The history of various chronic liver diseases as well as physical signs and laboratory indicators of liver function damage are the basis for diagnosis.

(3) Malnutrition edema:

Chronic wasting disease, long-term nutritional deficiency, protein-losing gastrointestinal disease, severe burns, hypoproteinemia, vitamin B1 deficiency, etc. can all cause edema. Tissue relaxation and decreased tissue pressure caused by a reduction in subcutaneous fat will aggravate water retention. Edema often spreads gradually from the feet to the whole body.

(4) Systemic edema due to other causes:

① Myxedema: When hypothyroidism is severe, the skin is infiltrated by mucin and mucopolysaccharide, resulting in characteristic non-pitting edema, called myxedema. It often occurs on the face and anterior tibia. ②Drug-induced edema: The use of certain drugs can cause edema, which is characterized by mild edema after medication and gradually disappears after stopping the medication. The more common drugs are cortical hormones, testosterone, estrogen, insulin, etc. Excessive doses of Rauwolfia, thiourea and licorice can also cause edema. ③ Premenstrual syndrome is also a common cause of edema, which is characterized by mild edema of the eyelids, ankles and hands 7 to 14 days before menstruation, which may be accompanied by breast tenderness and pelvic heaviness. After menstruation, urine volume increases, and edema and other neurotic symptoms gradually subside. ④ Idiopathic edema: It mainly manifests in the sagging parts of the body, more common in obese adult women, often related to emotional and mental changes, accompanied by neurasthenia symptoms such as fatigue, dizziness, headache, anxiety, insomnia, etc., and the standing and supine water tests are positive.

Renal edema in pregnant women needs to be differentiated from the above four types of diseases. Renal edema in pregnant women is harmful to the health of both the pregnant woman and the fetus. After the disease occurs, some physical symptoms should be observed. If the fetus cannot be preserved, the pregnancy should be terminated to avoid the fetus being too large to threaten the safety of the pregnant woman and it is more likely to cause fetal developmental abnormalities. Therefore, after pregnancy, we must observe physical discomfort and have regular prenatal checkups to detect abnormal symptoms and more accurately diagnose diseases.