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  • Swelling in Pregnancy: Are You Prone to Pagmamanas?

    Swelling of the legs, ankles, and feet are common during pregnancy. About 75 to 80 percent of pregnant women experience it.
    by Rachel Perez .
Swelling in Pregnancy: Are You Prone to Pagmamanas?
PHOTO BY iStock
  • In 2019, singer-actress Jessica Simpson shared a photo of her swollen foot on Instagram during her third pregnancy and after giving birth. So did reality star Kim Kardashian in 2013, during her first pregnancy. The images are a fitting visual of just how huge a preggo's legs, ankles, and feet can get and enough to assure expecting women that they are not alone.

    Swelling (pagmamanas) of the legs, ankles, hands, and feet while pregnant is a typical pregnancy symptom. About 75 to 80 percent of pregnant women experience it. For some, it can start as early as the second trimester, or Week 15. More commonly though, swelling (the medical term for which is "edema") in pregnancy peaks in the third trimester.

    Swelling in pregnancy is primarily caused by increased blood and fluid production

    During pregnancy, your body produces 50 percent more blood to sustain your growing baby. This means that your veins are carrying and circulating more blood than usual. A pregnant woman’s elevated hormone levels, particularly the hormone estrogen, can also make the walls of your veins softer.

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    Because of this, small amounts of blood leak through tiny blood vessels into the tissues. This, coupled with more fluid retention, lead to swelling. No wonder preggos feel swollen or bloated most of the time.

    “As the uterus grows, it exerts pressure on your veins and lymphatic tissue, which are responsible for returning blood to the circulation,” explains Kameelah Phillips, M.D. It may affect blood circulation on your vena cava, the major blood vessel on the right side of your body where blood from your lower extremities passes on its way back to your heart, which is why it’s more common during the third trimester and on the legs, ankles, and feet. Swelling during pregnancy, however, is not restricted to the lower limbs.

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    Preggos are also often advised to watch what and how much they eat, and to engage in regular low-impact exercises to promote blood circulation. Too much weight gain and lack of physical activity during pregnancy are two other reasons that may make swelling worse.

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    The bright side is that there is a purpose for this swelling: The American Pregnancy Association says the body retaining extra fluid, which accounts for about 25 percent of the weight preggos gain during pregnancy, is needed to “soften the body” and “enable it to expand” as the baby grows. It also helps prepare the pelvic joints and tissues to open for delivery.

    Swelling is a common cause of other pregnancy symptoms

    With the increased blood volume coursing through your veins, swelling in pregnancy can occur on any part of the body, and is often a culprit for other not-so-common pregnancy symptoms. These include:

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    • In your legs, ankles, and feet, swelling can cause varicose veins. It can make your feet bigger, and you may need bigger-sized shoes to make walking more comfortable.
    • In your nose, it can lead to stuffy, congested airways or nosebleeds. Swelling in the vocal cords may alter a pregnant woman’s voice pitch.
    • In your gums, swelling may cause them to be more sensitive and prone to bleeding. Remember to schedule at least one visit to your dentist to keep your oral health in check.
    • In your eyes, it can lead to blurred vision, temporary near- or farsightedness, or impaired peripheral vision, due to the pressure in the veins at the back of your eyes.
    • In your hands and fingers, swelling can cause numbing and pain that can lead to carpal tunnel syndrome.
    • In your breasts, you may feel tender or sore. (Your breasts are also preparing to produce milk.)
    • In your vaginal area, swelling can cause your vulva or your vagina to be engorged, and may make sex feel painful.

    Don’t worry, though—many of these pregnancy symptoms should resolve by themselves soon after you give birth, when your body gets rid of the excess fluid (it’s why you may sweat or pee a lot after birth).

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    How to prevent swelling in pregnancy

    Some women experience swelling a lot worse than others do (while others don’t have it at all). It has nothing to do with the gender of your unborn baby. A popular theory suggests swelling in pregnancy depends on the genes. But every pregnancy is different, and a pregnant woman may experience swelling during her first pregnancy but not in her second.

    It all boils down to preventing and managing the swelling, so it doesn’t get in the way of a pregnant woman’s daily activities. While mild swelling of the ankles and feet is typical, it can go from harmless to uncomfortable if left unchecked. Here are some ways to prevent and manage it:

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    • Avoid standing (or sitting) for long periods. Stretch your legs and take regular breaks from standing or sitting. Try not to cross your legs when sitting.
    • Put your feet up (higher than your head) whenever possible. Prop pillows to put your feet up when lying down. Use a stool or a pile of books under your desk at work.
    • Sleep on your left side. This can help take the pressure off the veins that return blood from your lower limbs back to your heart.
    • Commit to a simple pregnancy exercise regimen. Take regular walks or ride an exercise bike. Walking or swimming laps in a pool helps as well.
    • Eat healthily. Avoid consuming too much caffeine and foods with too much salt. Opt for foods rich in potassium, such as bananas and avocado, to help reduce swelling.
    • Stay hydrated. Drinking more water, about eight to ten glasses a day, can help prevent fluid retention.
    • Wear loose clothing and comfortable shoes to prevent restricting blood flow even more.
    • Wearing compression socks or stockings may help, too. Avoid socks that have a tight elastic or garters on top.
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    When should you worry about swelling during pregnancy?

    Swelling during pregnancy might be common, but it’s crucial to keep your doctor up to date about your condition so she can help manage the swelling. It can also be a warning sign for a few pregnancy complications that need urgent medical attention. See your doctor immediately and don’t wait for your next prenatal checkup if you notice the following:

    • Pain, tenderness, redness, or hardness on any swollen part of your body
    • Uneven swelling (e.g., one leg is more swollen than the other)
    • Swelling in your face or hands
    • Headaches
    • Lightheadedness, dizziness
    • Pain in your lower abdomen or pelvic area
    • Difficulty breathing
    • Fever

    Preeclampsia

    If you’re having severe headaches, dizziness, and notice sudden and excessive swelling, it may be a sign of preeclampsia. It is also characterized by increased blood pressure and protein in the urine during pregnancy. If left unchecked, it can damage a woman’s kidneys, liver, brain, cardiovascular system, and other organs. It can also develop into eclampsia, a much more severe pregnancy complication which can cause seizures or a coma (Find out if you’re at risk for developing preeclampsia here.)

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    Deep vein thrombosis

    If you notice that only one of your legs is swollen, or one is significantly more swollen than the other, with pain or hardness, it may be a sign of deep vein thrombosis (DVT) or blood clots that form in veins deep within a part of the body, usually in the legs. This may interfere with blood flow. With increased blood production, preggos' bodies also produce more of the protein that helps your blood clot to prepare your body for childbirth. If this breaks loose, it can travel through the bloodstream to the lungs and cause pulmonary embolism, a life-threatening condition.

    Cellulitis

    If you develop a fever and notice an expanding rash or redness on a swollen area of your skin, it could be cellulitis, a common, potentially life-threatening bacterial skin infection. It typically affects the skin on the lower legs, but can also occur in the face, arms, and other areas. The affected skin area may also have spots, blisters, or dimples, and be painful and warm to the touch. It’s rarely infectious, but if left untreated, can spread to the lymph nodes and bloodstream.

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    Swelling during pregnancy can also be an indicator of a heart or respiratory issue, albeit rarely. Remember, when in doubt, always consult your doctor.

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