Doctor Consultation for Swelling and Edema

Mild swelling, particularly in the feet, ankles, and legs, is a common experience during pregnancy, especially in the second and third trimesters. This physiological edema results from increased blood volume, hormonal changes that cause fluid retention, and the growing uterus pressing on pelvic veins, which slows the return of blood from the lower extremities.

Normal pregnancy swelling tends to worsen as the day progresses, particularly after prolonged standing or sitting, and often improves with rest and elevation of the legs. In hot and humid conditions common in Visakhapatnam, swelling may be more pronounced. This type of swelling is generally benign and does not indicate a medical problem.

However, not all swelling during pregnancy is harmless. Sudden onset, rapid progression, or swelling that occurs in unusual locations can signal underlying conditions that require medical evaluation. Understanding the difference between normal and abnormal swelling is important for timely intervention.

Swelling that develops suddenly, particularly in the face, hands, or around the eyes, should be reported to the doctor immediately. Unlike the gradual lower extremity swelling that most pregnant women experience, sudden facial or hand swelling can be an early sign of preeclampsia, a serious condition characterised by high blood pressure and protein in the urine.

Swelling that is significantly more pronounced in one leg than the other, especially if accompanied by pain, redness, or warmth, may indicate deep vein thrombosis, a blood clot in the leg veins. Pregnancy increases the risk of blood clots due to changes in the clotting system, and this condition requires urgent medical treatment to prevent complications.

Swelling accompanied by high blood pressure, persistent headaches, visual disturbances, or upper abdominal pain constitutes a medical emergency. These symptoms together suggest preeclampsia, which can progress rapidly and endanger both mother and baby. Immediate medical evaluation and treatment are essential.

When an expectant mother presents with concerning swelling, the doctor performs a thorough evaluation. Blood pressure measurement is the first step, followed by urine testing for protein. Blood tests assessing kidney function, liver function, and platelet count provide additional information about whether preeclampsia or another condition is developing.

Physical examination includes assessing the extent and distribution of swelling, checking for pitting edema by pressing on the skin, and evaluating for signs of deep vein thrombosis. The doctor also reviews recent weight gain trends, as sudden excessive weight gain can indicate fluid retention beyond normal pregnancy changes.

For normal physiological swelling, doctors recommend several practical measures. Elevating the legs when sitting or lying down helps fluid drain from the lower extremities. Avoiding prolonged standing or sitting in one position and taking regular short walks improve circulation. Wearing comfortable shoes and avoiding tight clothing around the ankles also helps.

Adequate hydration is important, as dehydration can paradoxically worsen fluid retention. Reducing excessive salt intake can help, but salt restriction should not be extreme, as sodium plays important roles during pregnancy. The doctor can advise on appropriate dietary salt intake based on individual circumstances.

Compression stockings may be recommended for women with significant but benign swelling. These garments apply graduated pressure to the legs, helping blood and fluid return to the heart more efficiently. They should be put on in the morning before swelling develops and worn throughout the day.

If swelling is associated with preeclampsia, treatment shifts from lifestyle measures to medical management. Anti-hypertensive medications may be prescribed to control blood pressure. The mother may be hospitalised for close monitoring of blood pressure, urine output, blood tests, and fetal well-being.

In severe preeclampsia, the definitive treatment is delivery of the baby and placenta. The timing of delivery depends on the gestational age and the severity of the condition. Magnesium sulphate may be administered to prevent seizures. The decision to deliver involves balancing the risks of prematurity against the risks of continuing the pregnancy with a deteriorating maternal condition.

Most pregnancy-related swelling resolves within one to two weeks after delivery as the body eliminates excess fluid through increased urination and sweating. Temporary worsening of swelling in the first few days after delivery is common and generally not concerning, as the body redistributes fluid accumulated during pregnancy.

Women who had preeclampsia-related swelling require continued blood pressure monitoring after delivery, as the condition can persist or worsen postpartum. Any new onset of swelling, headaches, or visual changes after delivery should be reported to the healthcare provider promptly. Follow-up appointments ensure that the mother's recovery is progressing normally and that any ongoing issues are addressed.