Swelling In The Last Trimester Of Pregnancy

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Swelling In The Last Trimester Of Pregnancy

As the pregnancy progresses, fluid can build up in the tissues, usually in the feet, ankles, and legs, causing them to swell. This is called edema. Sometimes the face and hands also swell. It is normal for some fluid to accumulate during pregnancy, especially during the third trimester. It is called physiological edema. Fluid builds up during pregnancy because the adrenal glands produce more of the hormones that cause fluid retention ( aldosterone and cortisol ); it also builds up because the enlarged uterus interferes with the blood flow that returns blood from the legs to the heart. As a result, fluid is stored in the veins of the legs, leaking into the surrounding tissues. In this article, we will explain to you Swelling in the last trimester of pregnancy. Let’s start!

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Causes of swelling in the last trimester of pregnancy

Frequent causes

Usually, during pregnancy, swelling is

  • Physiological edema

Less frequent causes

Less commonly, swelling during pregnancy is caused by a disorder that is often serious. These include the following:

  • Deep venous thrombosis
  • Preeclampsia
  • Cellulitis

Deep vein thrombosis

Thrombi form in veins deep in the body, often in the legs. Pregnancy doubles the risk of this disorder in numerous ways. During pregnancy, the body produces more of the proteins that help blood clot (clotting factors), probably intending to prevent excessive bleeding during childbirth. Besides, changes during pregnancy cause blood to be stored in the veins, which is a favorable condition for the formation of thrombi. If the pregnant woman moves less, the blood is even more likely to stop in the veins in her legs and clot. Thrombi can interfere with blood flow. If a thrombus dislodges, it can travel through the bloodstream to the lungs and block blood flow there. Pulmonary embolism is life-threatening.

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In pre-eclampsia, blood pressure and protein levels in the urine increase during pregnancy. There may be fluid build-up, leading to swelling of the face, hands, or feet, as well as weight gain. If severe, preeclampsia can damage organs such as the brain, kidneys, lungs, or liver, and cause disorders in the baby.


In cellulite, bacteria infect the skin and tissues under the skin, sometimes leading to swelling with redness and tenderness. Cellulite appears most often on the legs, although it can be seen anywhere else on the body.

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Risk factor’s of swelling in the last trimester of pregnancy

The risk of deep vein thrombosis and preeclampsia is increased in various circumstances (risk factors).

  • Risk factors for deep vein thrombosis are:
  • Recent leg injury
  • The previous episode of deep vein thrombosis
  • Venous injury
  • A disorder that causes the blood to have a greater tendency to clots, such as cancer or sometimes systemic lupus erythematosus (lupus)
  • Cigarette smoking
  • Immobility, as can occur after illness or surgery

Risk factors for preeclampsia are:

  • High BP that was present before pregnancy
  • Preeclampsia is a previous or previous pregnancy in a family member
  • Be under 17 years of age or over 35
  • First pregnancy
  • Multiple pregnancies (with more than one fetus)
  • Diabetes
  • Blood vessel (vascular) disorders
  • Hydatidiform mole (overgrowth of placental tissue)


Deep vein thrombosis, cellulitis, preeclampsia, and other possible conditions must be ruled out before physiologic edema can be diagnosed.

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Warning signs of swelling in the last trimester of pregnancy

When a pregnant woman has swollen legs, the presence of the following symptoms is a cause for concern:

  • Swelling in one leg or calf, especially if the area is hot, red, or tender, or if the patient has a fever
  • Blood pressure of 140/90 mm Hg or greater
  • Swelling in the hands
  • Swelling that suddenly increases
  • Confusion, shortness of breath, visual disturbances, tremors, seizures, sudden abdominal pain, or sudden headache, all symptoms that may be due to pre-eclampsia

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When to go to the doctor

You should go to the hospital quickly if you have:

  • Symptoms indicative of preeclampsia

If you have any other warning signs, you should see a doctor that day. If you do not have any warning signs, you should also go to the doctor, although there is no danger of delaying the consultation for several days.

Doctor’s performance

First, the doctor asks about the swelling, other symptoms, and the woman’s medical history. Next, perform a physical examination. What they discover during the history and physical examination usually implies a cause of the swelling and the tests that may need to be done.

Doctors ask about the following:

  • When did the swelling start
  • How long has it been around
  • If there is any activity (such as lying on the left side) that makes it easier or worse.

Lying on the left side reduces physiological edema.

They also ask about conditions that increase the risk of deep vein thrombosis and preeclampsia.

Also, ask about other symptoms that may indicate a cause. You wonder if you have ever had deep vein thrombosis, pulmonary embolism, pre-eclampsia, or high blood pressure.

During the physical examination, they look for signs of a serious cause. To detect possible symptoms of pre-eclampsia, the doctor measures blood pressure and listens to the heart and lungs; You can also check the woman’s reflexes and view the fundus with an ophthalmoscope (a handheld device similar to a small flashlight).

Supplementary tests

If deep vein thrombosis is suspected, a Doppler ultrasound of the affected leg is performed. This test can show disturbances in blood flow caused by thrombi in the veins of the legs.

If preeclampsia is assumed, the protein level is estimated in a urine sample. Hypertension along with a high level of protein in the urine indicates preeclampsia. If the diagnosis is unclear, the woman is asked to collect urine for 24 hours to measure the protein concentration in that volume of urine. This measurement is more accurate.

Treatment of swelling in the last trimester of pregnancy

When swelling is due to a disorder, it must be treated.

Normal pregnancy swelling can be reduced by doing the following:

  • Lie on the left side, so that the uterus separates from the large vein through which blood returns to the heart (inferior vena cava)
  • Rest often with your legs elevated
  • Wear elastic compression stockings
  • Wear loose clothing that does not restrict blood flow, especially in the legs (for example, do not wear socks or stockings with tight bands at the ankles or calves). In this regard, we invite you to read: Is It Advisable To Wear a Maternity Bra?

Key concepts

  • Some swelling in the legs and ankles is normal (physiological); it is seen in the third trimester of pregnancy.
  • Your doctor can find serious causes of swelling from the results of a physical exam, blood pressure measurement, urinalysis, and sometimes ultrasound.
  • If the cause is the pregnancy itself, the swelling can be reduced by lying on the left side, elevating the legs periodically, wearing compression stockings, and wearing clothing that does not restrict blood flow.

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