Symptoms that should not be ignored during pregnancy - edema

This is the 4645th article of Da Yi Xiao Hu

Dandan's happy family

Dandan, 39 years old, has a happy family and already has a 15-year-old son. Thinking that she is in good health, Dandan decided to have a second child. After the National Day last year, Dandan got pregnant as she wished.

With the joy of pregnancy, Dandan did all the prenatal checkups in the early pregnancy. The doctor told her that both mother and child were in good condition, but she needed to take medicine to prevent gestational hypertension, control her weight, and gain weight properly during pregnancy. Dandan listened to the doctor and did prenatal checkups on schedule for the first five months. The results showed that all indicators were normal and the baby in her belly was developing healthily. Later, Dandan did not pay much attention to prenatal checkups.

Almost a tragedy

After 6 months of pregnancy, Dandan developed edema in both lower limbs. At first, it was only in the ankles, but it got better after a good night's sleep. Half a month later, the edema gradually spread to the calves, and when she pressed with her hands, a pit could be made. Dandan remembered that during her first pregnancy, her feet also swelled up and it was difficult to wear shoes. She needed to put a pillow under her feet when she slept, so she didn't take it too seriously.

In the 7th month of pregnancy, Dandan found that the edema was getting worse and worse, and even the perineum and abdominal wall were swollen. Until one morning in the 8th month of pregnancy, she felt dizzy and had a headache, which became more and more severe, and she said she "fainted". When she was sent to the hospital, Dandan's blood pressure was as high as 240/140mmHg, and her lower lip was bitten. The doctor speculated that she might have "prenatal eclampsia". Although the mother and child had a good outcome after rescue, the first symptom of "edema" was not taken seriously, which almost caused a family tragedy in which the mother and child lost their lives.

Understanding Preeclampsia-Eclampsia during Pregnancy

Preeclampsia-eclampsia is a disease unique to pregnancy, which can cause damage to multiple systems of the mother, leading to adverse pregnancy outcomes such as heart failure, pulmonary edema, premature birth, fetal distress, intrauterine fetal death, and in severe cases, maternal and fetal death. The disease is characterized by hypertension, edema, and proteinuria after 20 weeks of pregnancy as the main clinical manifestations, but edema discovered by pregnant women themselves is often the reason for the first visit. The purpose of reducing adverse maternal and child outcomes is achieved through early identification and standardized diagnosis and treatment.

The figure below shows the impact of hypertensive disorders complicating pregnancy on multiple systems of the mother and fetus.

Edema during pregnancy cannot be ignored

Any abnormal symptoms and signs during pregnancy should not be ignored. Today, let’s learn about edema during pregnancy so that it can attract the attention of pregnant women, their families and the whole society.

Physiological edema during pregnancy

During pregnancy, due to the increase in estrogen and progesterone levels, hypoproteinemia caused by blood dilution, and pressure from the gradually enlarging uterus, a series of physiological changes will occur in the body, including physiological edema of the lower limbs. Physiological edema is generally located below the knees and is heavier in the ankles. It can be relieved by resting at night or raising the lower limbs.

Pathological edema during pregnancy

The most common pathological edema is gestational hypertension, which occurs after 20 weeks of pregnancy. In addition to edema, patients also suffer from hypertension, proteinuria or damage to other organ functions. For example, Dandan in this article developed gestational hypertension after 7 months of pregnancy. Kidney disease is also a common cause of edema during pregnancy. In addition, if pregnancy is complicated by systemic diseases such as heart failure and liver disease, edema may also occur. Therefore, edema during pregnancy should not be regarded as a physiological or normal phenomenon, and should not be taken seriously, delaying the treatment of the disease.

Grading of edema during pregnancy

Grade I: edema below the knee; Grade II: edema spreads to the thigh; Grade III: edema of the perineum and abdominal wall; Grade IV: generalized edema and pleural and abdominal effusions. For hypertensive disorders complicating pregnancy, some patients may not show obvious edema, but may show rapid weight gain, i.e. "hidden edema". Patients with hidden edema mainly show more serious signs such as pleural and abdominal effusions.

In addition, during pregnancy, you should also pay attention to unilateral lower limb edema. If one lower limb is normal and the other is edematous, you should be alert to deep vein thrombosis in the lower limbs. Deep vein thrombosis is another common disease that endangers the life safety of pregnant women during pregnancy. If pregnant women have unilateral lower limb edema, do not easily think that it is caused by "compression from sleeping in the side-lying position". Be sure to see a doctor for further diagnosis, and rule out or treat deep vein thrombosis in the lower limbs.

Therefore, do not ignore edema, a common symptom during pregnancy. Every pregnant woman should be the "first person responsible for her own health", standardize pregnancy care, conceive the fetus scientifically, go through the hardships of "ten months of pregnancy", give birth to a healthy and smart baby, and fulfill the family's dream of happiness!

(The picture comes from the Internet, for popular science purposes, thanks to the author of the picture)

Author: Datong Third People's Hospital

Obstetrics Department Chief Physician Wang Xiaoqing