PREGNANCY-BIRTH Messages for April, 1999: Re: Why check for edema?

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Re: Why check for edema?

From: William D. McIntosh, MD (anonymous@obgyn.net)
Tue, 27 Apr 1999 15:09:23 -0500 (CDT)

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At Mon, 26 Apr 1999, AMD wrote: >
>My OB checks my legs for edema at every visit now. Last time he said
>there was "half a dent". Is edema in the legs significant somehow, even
>if BP is normal? Why check for edema if the BP is normal?
>
>I've noticed my leg and ankle swelling is worse the last couple of
>weeks, and by Friday afternoon, my legs definitely have that "doughy"
>thing where pushing with a finger leaves a dent for a minute or so.
>
>Why does the swelling get worse when I sit at my desk at work, but I
>have almost no swelling on the weekend when I'm running errands? I
>thought the swelling came from being on your feet too much.
>
>Thanks,
>Andrea
>EDD 7/7

Edema, protein in the urine and elevated blood pressure are the 3 signs of pregnancy induced hypertension (aka, toxemia), but you only need 2 of the 3 to make the diagnosis. I have seen more than one patient have eclamptic seizures without any trace of elevated blood pressures. Symptoms like PIH headaches and visual disturbances are usually late findings. Hopefully, we already have an idea that something is going on prior to the appearance of those things.

Having said that, your swelling sounds fairly typical. Anytime you are immobile, with your legs lower than your heart, your swelling will increase. Muscle movements of the legs act to "pump" the fluid back to the torso, and gravity is a big help if you can get your legs up. Immersion in water exerts hydrostatic pressure in a uniform fashion, and is an excellent way to combat edema of the extremities.

-- William D. McIntosh, MD Clarksville, TN

This is for educational purposes only. It is not intended to replace consultation and examination by your physician or other health care provider.

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