When is swelling not normal during pregnancy?

Pregnancy is one of the most beautiful phases in a woman’s life, but it also comes with its challenges. The pregnancy period can look different for different women — for some, it is a smooth experience until the ninth month, but for others, there are many discomforts. According to Dr Shefali Tyagi, consultant — obstetrics and gynaecology, Motherhood Hospital, Sarjapur, Bangalore, one such discomfort is when you find your hands or feet to be visibly swollen.
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What factors contribute to normal swelling when you are expecting?
“Your uterus expands in size, because of which there is pressure on the veins of the lower half of your body, which constricts blood flow to the heart. This also results in fluid retention in the veins that can also penetrate adjoining tissues. Certain hormonal changes also contribute to the swelling,” the doctor explains, adding that hands and feet swell up during the later stages of pregnancy.

She adds that it is also referred to as ‘physiological edema’, and is especially common during the third trimester and mostly benign. “The swelling may worsen as the day progresses as extra fluid may accumulate in the body parts that are located farthest from the heart. A gradual increase in the swelling as your due date nears is completely normal,” says Dr Tyagi.
The gynecolog shared the following tips to combat this swelling:
1. Avoid exposure to hot or humid weather for prolonged intervals.2. It is advised to not stand for long hours and to engage in warm massages regularly so as to aid blood circulation.3. When you are sitting or lying down, make sure to keep a pillow under your feet to avoid cramping.4. You should also reduce your sodium (salt) intake when pregnant as it makes your body hold on to extra water.5. Caffeine is also not advised as it dehydrates your body further, causing your body to retain more fluid, worsening swelling.6. You need to stay hydrated at all times.7. Try wearing comfortable footwear.

When is swelling not normal during pregnancy?
Dr Tyagi says swelling during pregnancy is usually normal and goes away in a few weeks postpartum. But, there are instances when swelling in the feet and hands requires urgent medical intervention.
* Pre-eclampsia: Pre-eclampsia is characterised the sudden onset or tremendous increase in swelling, which is not limited to your hands or your feet, but can also be felt on your face and around your eyes. It can also cause a sudden weight gain and a consently high blood pressure. This condition affects only 5-8 per cent of pregnant women, but watch out for such symptoms.

* Deep vein thrombosis: Since blood circulation to the legs during pregnancy is hampered, there are chances you may experience blood clots in your legs and hands, causing them to swell. Your blood will clot more easily because your body is preparing to reduce blood flow at the time of your delivery. Such a condition is referred to as ‘deep vein thrombosis‘ that can cause excessive swelling in your limbs and pain/tenderness.
“In a general scenario, swelling in the hands or feet can be accompanied several other symptoms, which could be a cause of concern such as: blood pressure higher than 140/90 mm Hg, fever and sudden headache, changes in vision, swelling in only one leg/calf and a warm pain radiating in the area,” the doctor concludes.
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