Month 6: Puffy much?

Swelling in pregnancy is a common occurrence, and most of us will have experienced some form of fluid retention towards the end of pregnancy.

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, like high blood pressure. Each woman retains fluid according to her individual needs. If you’re overweight during pregnancy, you will retain more fluid than a woman who’s underweight. Even if you show no signs of swelling, you’re carrying an increased amount of fluid in your body 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.

WHEN IS SWELLING A PROBLEM?

You’ll notice that by the end of a day, when you’ve 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 (as it’s called) 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, that is, 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 your feet up 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 won’t disappear as quickly when you elevate the affected part.

HOW CAN YOU TELL WHICH IS WHICH?

One way to tell the difference between normal and abnormal swelling 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’s not quite done, tissues won’t spring back when you press the swollen area on your ankles or feet – it remains dented. Report any increase in swelling as well as any puffiness around the face and eyes and in your hands. These changes could signify the onset of pre-eclampsia or pregnancy-induced hypertension, which is a pregnancy-related condition that’s associated with high blood pressure. ●