The agony of swollen ankles during pregnancy
Different causes of edema in pregnancy
The swollen feet and ankles during pregnancy are caused by the uterine pressure and general fluid retention. The pregnant mother may become aware of it is she takes off her shoes and then can’t get them back on again comfortably. As long as proteinuria (presence of protein in the urine) and hypertension are not present, swollen ankle while pregnant is normal occurrence.
Another cause of edema during pregnancy is the fluid retention. However, this rationale is depended with underlying condition such as hypertension. The body of the pregnant mother retains the fluid which accumulates at the interstitial parts of the tissue causing swollen feet and ankles. It is advisable for the pregnant mother to undergo maternal checkup in case that they have observed swelling on their feet and ankle.
The kidney which is responsible for filtering the blood of the body has an essential role with the elimination of excess fluids. However, if the pregnant mother has a problem with the kidney during pregnancy such as diabetic nephropathy can also cause swollen ankle while pregnant. The kidney fails to provide normal glomerular filtration which in return can retain the body fluids inside the body. Aside from kidney, the brain which releases antidiuretic hormone (ADH) is hyperactive. This manifestation is brought by the endocrine problems of pregnant women during pregnancy. Antidiuretic hormones are responsible for eliminating the waste products in form of urine through urination, sweating, defecating and other sources of elimination. If the ADH exceeds the normal level in the blood, it will prevent the body to eliminate the excess fluid in the body which will accumulate and later can lead into swollen ankles during pregnancy.
Another cause of swollen feet during pregnancy is hypertension related to pregnancy. Protein which is a substance that remains in the body must not be present in the urine. The purpose of the kidney is to filter the blood to remove the toxic products. However, if the permeability of the kidney fails to screen the toxic substance causing the protein to pass the urine can lead to proteinuria. This manifestation is a sign of hypertension during pregnancy. Additionally, the increase level of sodium in the blood level can also help retain the water in the body. As the saying goes “where sodium goes, water follows” is applied. The sodium remains high in the blood the water remains high in the body as well. This can lead to the swollen feet during pregnancy.
Tips on how to reduce swelling in feet
To help relieve swollen feet during pregnancy, inform the pregnant mother to rest in a left side-lying position, this increases kidney glomerular filtration rate. Sitting for half an hour in the afternoon and again in the evening with the legs elevated should also help. Tell the pregnant mother to avoid constricting panty girdles or knee-high stockings because these garments impede lower extremity circulation and venous return.
Don’t discount a report of lower extremity edema until you are certain that the pregnant woman does not exhibits signs of proteinuria, edema of other nondependent parts, sudden weight increase that is indicative of pregnancy induced hypertension (PIH).
In addition to prevent swollen ankles during pregnancy, the pregnant mother is advised to avoid standing for a long period of time. They need to rest or sleep with their legs elevated. This is to promote venous return and proper blood circulation to the lower extremities. The pregnant mother must not wear constrictive clothing to their lower extremities that can impede the blood flow.
Below is the list of recommended teachings for pregnant mother with swollen feet and ankle during pregnancy:
- They are recommended to lie on their left side in bed to enhance the glomerular filtration rate of the kidneys;
- Urge them to observe dorsiflexion to their feet when standing or sitting for prolonged periods of time;
- Suggest that they must get up and move every 1 to 2 hours when sitting for longer period.
- Teach them about the effects and causes of edema;
- Encourage to perform regular maternal exercises and modify their eating habit.