Swelling and sum­mer

Swelling in preg­nancy is a com­mon oc­cur­rence, and even more so in the sum­mer heat. Here’s why it hap­pens, and what you can do about it, writes Tina Otte

Your Pregnancy - - Contents -

PUFFI­NESS OF THE wrists and an­kles dur­ing preg­nancy is caused by the ac­cu­mu­la­tion of fluid in the tis­sues. This is prob­a­bly due to the changes in the car­dio­vas­cu­lar sys­tem, caus­ing the blood ves­sels close to the sur­face of the skin to be­come more di­lated in re­sponse to the in­creased blood vol­ume. Even though a cer­tain amount of fluid re­ten­tion is nor­mal, too much can be­come un­com­fort­able and could lead to cer­tain health prob­lems, such as high blood pres­sure. Each woman re­tains fluid ac­cord­ing to her in­di­vid­ual needs. An over­weight preg­nant woman will re­tain more fluid than a woman who’s underweight. Even women who show no signs of swelling carry an in­creased amount of fluid in their bod­ies dur­ing preg­nancy.

WHY SO WA­TERY?

There are a num­ber of rea­sons for retaining fluid in preg­nancy (this is reg­u­lated by the in­flu­ence of hor­mones). The ex­tra fluid that you carry helps your body to pro­duce enough am­ni­otic fluid for your baby. This liq­uid pro­tects your baby from knocks and bumps and changes in tem­per­a­ture. You need a big­ger amount of cir­cu­lat­ing blood/flu­ids to meet the de­mands of your grow­ing baby, as well as to help get rid of waste prod­ucts. The ex­tra vol­ume of wa­ter in your blood slows down your cir­cu­la­tion and this, to­gether with the ex­tra wa­ter in the tis­sues, causes swelling. In most women, swelling is more no­tice­able in the legs, es­pe­cially around the an­kles. This is be­cause the pres­sure of the grow­ing baby, to­gether with the in­creased blood vol­ume, makes it more dif­fi­cult for the blood to re­turn from the arms and legs to the heart. In the legs, how­ever, both grav­ity and the weight of the uterus on the veins slows down the re­turn flow. Swelling is of­ten re­ferred to as oedema.

WHEN DOES SWELLING BE­COME A PROB­LEM?

You’ll notice that by the end of a day, when you have been up and about and stand­ing a lot, your an­kles will be swollen and your shoes may be too tight. This kind of swelling or oedema is known as de­pen­dent oedema and is caused by the po­si­tion of the af­fected body part. When you stand for an ex­tended pe­riod of time, your feet are in the de­pen­dent po­si­tion, mean­ing, they’re lower than the rest of your body. Be­cause of this, grav­ity works against your veins as they at­tempt to move your blood from your legs to your heart. This type of swelling is tem­po­rary and will dis­ap­pear once you put up your feet and re­lax. Pit­ting oedema is more se­ri­ous. This usu­ally means that your body is retaining too much fluid. You may have puffi­ness in your face around the eyes and in your hands. This swelling will not dis­ap­pear as quickly when you el­e­vate the af­fected part.

HOW CAN YOU TELL WHICH IS WHICH?

One way to tell the dif­fer­ence be­tween nor­mal swelling and swelling that is not so good is to do the “cake test” on your puffy an­kles: Tis­sues swollen with de­pen­dent oedema will spring back af­ter be­ing pressed. If you have pit­ting oedema, much like a cake that is not quite done, tis­sues will not spring back when you press the swollen area on your an­kles or feet, and it re­mains dented.

NOT SO SWELL

Re­port any in­crease in swelling as well as any puffi­ness around the face and eyes and in your hands to your doctor. These changes could sig­nify the on­set of pre-eclamp­sia or preg­nancy in­duced hy­per­ten­sion (PIH) which is a preg­nancy-re­lated con­di­tion that is as­so­ci­ated with high blood pres­sure, and which can be dan­ger­ous.

IF YOU HAVE PIT­TING OEDEMA, MUCH LIKE A CAKE THAT IS NOT QUITE DONE, TIS­SUES WILL NOT SPRING BACK WHEN YOU PRESS THE SWOLLEN AREA

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