What You Need to Know About Leg Swelling (Edema) During Pregnancy

Leg Swelling (Edema) during Pregnancy-MainPhoto

Welcome to This Symptom Guide about Ankle and Leg Swelling during Pregnancy.

Almost every pregnant woman has some extra fluid in the tissues. Usually this will be most obvious during the later part of pregnancy, especially if a woman is on her feet for a long period of time.

However, sometimes leg swelling can indicate a complication of pregnancy or be caused by an unrelated problem.

This guide is not intended to replace a face-to-face meeting with a health care professional about your symptoms. Many causes of leg and foot swelling require an in-person examination and testing to diagnose. However, this guide may be particularly helpful while awaiting an office visit or after your initial evaluation.

Let’s Get Started

The reasons for swelling in just one leg are not the same as the causes of swelling in both legs.

Do you have swelling of just one foot, ankle, and/or leg? (Also answer yes if one side is much more swollen than the other side.)

Yes, the swelling is just on one side.

No, both sides are swollen.

Almost all women have some leg swelling during pregnancy. Usually the swelling is just a little at first, gradually increasing over time. However, sometimes leg swelling in pregnancy can be caused by a condition that requires immediate attention.

If you had sudden onset of swelling in both legs, it may indicate a condition called preeclampsia. Preeclampsia is a condition of pregnancy in which a woman develops high blood pressure, spills protein in her urine, and holds on to excess water, causing swelling of the legs and other parts of the body.

Does one or more of the following apply to you?

  • The swelling is really bad
  • Face and/or hands are also swollen
  • New headache
  • Visual changes
  • Nausea that was not present before
  • Vomiting
  • Belly pain

Yes, I am having one or more of those symptoms.

No, I do not have any of those symptoms.

That’s good news. If the swelling continues to increase prior to your next scheduled prenatal appointment, call for advice.

Now it’s time to learn about other causes of leg swelling that may or may not be related to pregnancy.

Click here to continue.

You may have preeclampsia. Call your doctor, nurse practitioner, or midwife now.

With a few simple tests, your health care professional can rule out preeclampsia. These tests usually include a blood pressure measurement, tapping on your reflexes to see if they are hyperactive, a urine test for protein, and often a blood test to make sure your blood count, liver enzymes, and kidney function are normal.

After making the call, you can come back to the guide to learn about other reasons for leg swelling.

Click here to continue.

Sometimes arthritis will cause swelling in both feet and ankles. Usually the swelling does not travel up the leg. Also with arthritis, there is almost always some pain.

Do you think the swelling might be caused by arthritis?

Yes, I think so.

Nope, doesn’t sound like me.

Shortness of breath with swelling in both legs suggests certain medical problems.

Do you have shortness of breath, especially with physical exertion?

Yes, I have developed shortness of breath.

No, not a problem.

Call your doctor’s office to arrange an appointment. Several types of inflammatory arthritis, such as rheumatoid arthritis, can start this way.

After calling you doctor, you may wish to learn about other causes of leg swelling.

Click here to learn more.

Glad to see you opted to continue with the guide, because it may be something other than arthritis.

Shortness of breath with swelling in both legs suggests certain medical problems.

Do you have shortness of breath, especially with physical exertion?

Yes, I have developed shortness of breath.

No, not a problem.

Excellent.

Certain types of liver and kidney problems can cause swelling of the feet, ankles, and legs. People with liver problems, such as cirrhosis, will almost always have a swollen belly. People with a type of kidney disease called nephrotic syndrome often notice that they have a lot of swelling around the eyes when they wake up in the morning.

Choose the description that applies to you:

My belly is swollen.

My eyes are puffy in the morning.

I only have leg swelling.

Okay. So far your answers indicate that you just have swelling in your legs without pain that might suggest arthritis.

Does your lower extremity swelling seem to occur after you eat salty foods?

Yes, I have noticed that.

No, that’s not true for me.

Your doctor will want to make sure that you are not spilling protein into your urine or having some other kidney problem. However, many people who retain fluid and are otherwise healthy have puffiness of the eyes in the morning.

Call your doctor’s office to arrange an appointment.

Click here to learn more.

The swelling may be related to your liver, especially if you have had liver problems.

Call your doctor’s office to arrange an appointment.

Click here to learn more.

Call your doctor to arrange prompt medical evaluation. Medical conditions that cause shortness of breath and leg swelling include:

  • Heart failure
  • Chronic lung disease, such as chronic bronchitis and emphysema
  • Anemia

After calling you doctor, you may wish to learn about other causes of leg swelling.

Click here to learn more.

Salt can cause you to retain more fluid.

Does your lower extremity swelling seem to occur after you eat salty foods?

Yes, I have noticed that.

No, that’s not true for me.

All right — that makes salt retention as a cause of your swelling less likely.

Here’s the next question.

Have you started any new medications lately?

Yes, I have started a new medication.

No, I have not started any new medications.

You may have leg swelling due to salt retention. For some people who are sensitive to salt intake, this can be a real problem. But the solution is pretty straightforward: salt restriction.

Here’s another question that can help sort out the cause of leg swelling.

Have you started any new medications lately?

Yes, I have started a new medication.

No, I have not started any new medications.

Good, that makes it less likely that your lower extremity swelling is due to a medication you are taking.

But even a medicine you’ve been taking a while can cause leg swelling, so talk to your doctor about this possibility. Examples include nifedipine (Procardia, Adalat, or Nifedical) and pregabalin (Lyrica).

Click here to finish the guide.

Even after evaluation by your doctor, there may be no clear explanation for your leg swelling. That’s because you could be one of the millions of people with “idiopathic edema” — that means no specific cause can be found.

One reason this happens is that, as we age, the valves in our leg veins begin to work poorly. Normally, these valves prevent fluid from collecting where gravity takes it, such as the feet and lower legs. When the veins don’t work well, swelling in the feet and legs is common. With this condition, lower extremity swelling tends to occur at the end of the day and resolve entirely (or mostly) after leg elevation, as during sleep. Treatment usually includes salt restriction, tight (compression) stockings, and leg elevation.

We hope you feel better soon!

Okay, that’s helpful to know. A number of medications can cause lower extremity swelling. Examples include nifedipine (Procardia, Adalat, or Nifedical) and pregabalin (Lyrica).

Click here to finish the guide.

Even after evaluation by your doctor, there may be no clear explanation for your leg swelling. That’s because you could be one of the millions of people with “idiopathic edema” — that means no specific cause can be found.

One reason this happens is that, as we age, the valves in our leg veins begin to work poorly. Normally, these valves prevent fluid from collecting where gravity takes it, such as the feet and lower legs. When the veins don’t work well, swelling in the feet and legs is common. With this condition, lower extremity swelling tends to occur at the end of the day and resolve entirely (or mostly) after leg elevation, as during sleep. Treatment usually includes salt restriction, tight (compression) stockings, and leg elevation.

We hope you feel better soon!

Sudden onset of swelling in just one leg usually requires prompt medical evaluation. The exception might be if you sprained an ankle or injured a foot and the swelling was only localized to that area.

Is the swelling localized to the foot and/or ankle only?

Yes, it is localized.

No, the swelling extends up my leg.

Contact your doctor now.

Although lower extremity swelling is a common symptom and is often nothing too serious, you can’t be sure.

Concerns that your doctor might have include:

  • A blood clot in the leg (called a deep vein thrombosis or DVT)
  • An infection in the leg; usually there will also be some redness and warmth over the part of the leg
  • Bleeding into the leg secondary to an injury

These more serious causes usually cause pain as well as swelling.

More about a less serious cause of leg swelling.

Another cause of sudden calf swelling that is not serious is a ruptured Baker’s cyst. A Baker’s cyst is a collection of fluid behind the knee that can develop after a knee swells. They usually occur in people with arthritis. The cyst can tear with the fluid leaking down into the calf.

The fluid that leaks into the calf will eventually get reabsorbed.

Did you have a sprain or other injury to your foot or ankle?

Yes, I do have an injury.

No, not that I recall.

You still might have injured the foot or ankle without remembering an actual incident. But let’s assume that there was no injury.

An infection can cause swelling, but almost always there are other symptoms, including:

  • Pain
  • Redness
  • Warmth over the area that is most painful

Do you have symptoms that suggest a possible infection?

Yes, it looks like an infection.

No, I only have swelling.

If you have any concern about your injury, call your doctor’s office for advice. Meanwhile, keep your foot elevated and apply ice.

To learn more about swelling in one leg, continue.

Click here to continue with the guide.

Glad you decided to continue.

Another cause of one sided foot and/or ankle swelling is an infection.

Additional symptoms of an infection usually include:

  • Pain
  • Redness
  • Warmth over the area that is most painful

Do you have symptoms that suggest a possible infection?

Yes, it looks like an infection.

No, I only have swelling.

That’s good. It is unlikely to be infection. Keep your foot and ankle elevated. If the swelling persists, call your doctor’s office for advice.

You need to be examined today. Call your doctor now or proceed directly to an urgent care setting.

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