Swelling of ankles and feet is a common problem during the last trimester or end of pregnancy. One of the reasons for this is an increase in fluid production and retention during pregnancy. Secondly, the enlarged uterus prevents the free flow of venous blood from the legs into the heart. This results in accumulation of fluid in the ankles and feet, that causes the swelling.
Mild swelling is usually considered to be normal during pregnancy and subsides within few weeks after delivery. Sudden and severe swelling, on the other hand, could be an indication of an underlying serious problem, which requires prompt medical treatment.
Causes of Ankle Swelling during Pregnancy
• The major cause of swollen ankles during pregnancy is an increase in fluid production and retention. The excessive fluids are necessary to support and nourish the fetus, prepare the pelvic joints and other related tissues for delivery, and make up for the blood loss during the delivery. Accumulation of these fluids in the lower limbs results in edema.
• Another factor that causes ankle swelling is the increased pressure on the blood vessels in the pelvis due to fetal growth in the uterus. The large uterus puts pressure on the inferior vena cava, the vein which carries blood from the lower half of the body to the heart. This pressure slows down the blood circulation, causing the blood to pool in the legs, resulting in fluid accumulation in the tissues of the feet and ankles.
• The hormonal changes that occur during pregnancy like changes in estrogen, progesterone, and other hormonal levels contribute to ankle swelling.
• Other minor factors which might contribute to swollen ankles during pregnancy are-
► Hot and humid climate
► Inadequate potassium in the diet
► Excessive consumption of salt and caffeine
► Sitting, standing or walking for a long period of time
Serious Causes of Ankle Swelling during Pregnancy
Certain causes of sudden and severe ankle swelling during pregnancy, which are considered to be dangerous and require immediate medical attention, are:
• Preeclampsia and eclampsia: Preeclampsia is a condition where a pregnant woman suffers from high blood pressure, fluid retention and is prone to seizures. The presence of seizures in such a patient is referred to as eclampsia. Besides sudden and severe swelling of ankles, other signs and symptoms of preeclampsia include severe headache, blurred vision, rapid weight gain, and vomiting. Women at risk are the ones aged more than 40 years or below 20 years. Family history and obesity are some of the other risk factors for preeclampsia.
• Swelling in only one leg accompanied by pain and tenderness in the calf or thigh muscles also requires prompt evaluation and treatment as it could be because of a blood clot in the deep veins. This clot could travel to vital organs like the heart or the brain with serious consequences.
• Other underlying medical conditions like heart or kidney disease, which could cause swelling of the feet, may have to be ruled out in some women.
Symptoms and Signs of Swollen Ankles During Pregnancy
The swelling of the ankles and the feet may result in-
• A feeling of tightness around the feet
• Shininess of the skin
• Warmth of the swollen feet
Swelling associated with redness, pain, red streaking, weakening of the skin and bruising may be due to a serious medical problem and should be looked into promptly.
Prevention and Treatment of Swollen Ankles During Pregnancy
Swelling of feet during pregnancy can be prevented to some extent by adopting the following practices-
• Avoid standing for long periods of time
• Relax or rest your feet as often as possible while walking
• Use comfortable footwear. Use of supportive stockings, socks or tights may be advised in some cases.
• Avoid tight clothing
• Lie down with your legs elevated with the help of pillows
• Sleep on your left side. This posture helps reduce the pressure on the inferior vena cava and improves circulation
• Regular foot exercises help improve the blood circulation in the feet
• Drink plenty of fluids, usually 8-10 cups of fluids daily
• Avoid soft drinks and caffeine during pregnancy
• Reduce intake of salt/sodium in your diet
• Use cold water compresses on the swollen feet and ankles
• Foot massage helps improve blood circulation
• Mothers with certain conditions like diabetes should check their feet regularly