Lower Extremity Edema

– The information has been reviewed by Dr. Tam Ching Ting

EpidemiologyLower extremity edema is a common symptom amongst pregnant women. Clinically, about 80% of pregnant women will experience this symptom during pregnancy.What is Lower Extremity Edema?It refers to the accumulation of fluid in the lower legs that is caused by the pressure from the growing uterus on the inferior vena cava during the middle to late stages of the pregnancy. Blood cannot flow back to the main circulation from the legs easily and this leads to different degrees of lower extremity edema. If the condition is severe, doctors will need to conduct further tests to rule out the possibility of pre-eclampsia.

Symptoms
Symptoms

During pregnancy, a woman’s body will hold around 6kg more water (including fetal amniotic fluid). If lower extremity edema is present, it will make walking uncomfortable. The vast majority of women who experience lower extremity edema feel that the symptoms tend to become worse in the afternoon. To check if you have lower extremity edema, you may try pressing your calf with your thumb. If an indentation remains and it goes away slowly, it may be a sign of edema.

Potential Risks of Lower Extremity Edema
Potential Risks of Lower Extremity Edema

Although lower extremity edema is common amongst pregnant women, it can also be caused by other more dangerous complications, such as pre-eclampsia. Pre-eclampsia is characterized by high blood pressure that could lead to seizure, cerebral hemorrhage, and even damages to the liver and kidneys. It is a serious complication and can be life-threatening for both the mother and the baby. Pre-eclampsia usually begins after 28 weeks of pregnancy and can develop rapidly, even in women whose blood pressure was normal in the early stages. If pregnant women experience lower extremity edema and abnormalities are detected in their blood pressure or urine tests, they should raise their concerns to their doctors to rule out the possibility of pre-eclampsia.

Treatment
Treatment

For mild cases of lower extremity edema, the symptom can be relieved with methods such as elevating the lower legs regularly, wearing compression stockings, and reducing the daily salt intake. Expectant mothers should not try diuretics on their own without consulting a doctor, as improper medication may bring side effects to both the mother and the fetus.If pre-eclampsia is diagnosed, doctors will arrange treatment immediately including prescribing antihypertensive drugs. The fetus’ condition will be closely monitored to check if there are signs of hypoxia or growth restriction. In cases where it is necessary, early delivery may be arranged to ensure the health of the mother and the baby.

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