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Pregnancy and Childbirth: The answers

Edema (or swelling) of limbs in pregnancy and pre-eclampsia

You should not read too much in edema of the legs. 80% of pregnant women have some degree of swelling of limbs, mostly the feet, ankles and fingers (rings are tight!). Some will have gross edema without any hint of raised blood pressure.

 

The edema is largely a function of the normal physiological changes happening during pregnancy.

 

However, patients with pre-eclampsia have an increased tendency to develop pronounced edema which may also be more generalized, affecting such unusual areas as the face thereby causing puffiness.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The bottom line, however, is that the presence of edema does not diagnose or even suggest pre-eclampsia, and, more significantly, its absence does not rule out the condition or lessen its severity.

 

What to expect with pre-eclampsia

The aim is to ensure delivery of a healthy baby without putting the mother at risk.

 

If the condition is getting worse in spite of all the measures, prompt delivery is the only option. This is to prevent eclampsia, which could potentially seriously harm both the mother and the baby. It could even kill them.

 

If the mother is very far from term, the method of delivery is likely to be a cesarean section, as induction of labour is unlikely to be successful  at least, not quickly enough.

 

If the mother is closer to term, let's say 35-36 weeks of gestation (or more), induction of labour is a viable alternative. The mother's condition will be closely monitored all the time and, if it is seen to be worsening, the induction process may be halted and delivery achieved by cesarean section.

 

The decision on how to proceed will depend on a combination of factors including the severity of the condition, whether the mother can be induced, fetal condition (which may be compromised), and the mother's own wishes.

 

Each individual case is unique and there are no rules cast in stone.

 

Continues next page

 

 

Limb edema is quite common in pregnancy. Presence of edema by itself is not an indication of pre-eclampsia. The condition can present without edema.