Consultant – Orthopaedic Surgeon
Speciality interests include:
Lower extremity: trauma, sports surgery, knee, patella dislocation, tendon problems, foot and ankle surgery, and the management of degenerative joint disease in younger patients.
Visiting on Sep 21-22, 2019Request an Appointment
Why is leg edema common in pregnancy?
During pregnancy, many hormonal changes take place. Including increased levels of progesterone, estrogen, HCG and prolactin. These higher levels of hormones induce changes in vascular permeability, promoting extravasation of plasma with consequent edema.
Other manifestations that may occur due to these hormonal changes are the sensation of heaviness, paresthesia, cramp and the formation of varicose veins. Pregnancy is presumed to be a major contributory factor in the increased incidence of varicose veins in women, which may result in venous insufficiency and leg edema. With most of the women who develop problems with varicose veins during pregnancy, the symptoms appear during the first three months of pregnancy.
Why are our veins so important?
The most important role of the veins is ensuring that our blood flows back to the heart. To prevent the blood flowing backwards, the veins are designed with a series of valves. A varicose vein occurs when a valve weakens, putting more pressure on other valves and causing blood to stagnate. As the vein dilates, the walls of the veins stretch and sag, which allows the vein to swell in that region into a miniature balloon near the surface of the skin.
The veins in the legs are most commonly affected as they are working against gravity. During pregnancy, increased blood volume puts the veins under increased pressure. In addition, an increase in the hormone progesterone relaxes the muscular walls of the blood vessels. This makes it even more difficult for veins to move blood from the lower body back to the heart. The increasing weight of the growing uterus puts pressure on the pelvic veins and on the inferior vena cava. This increases blood pressure in the leg veins, and thus influences the development of varicose veins.
Varicose veins can lead to venous insufficiency and leg edema. The slowing down of the circulation causes blood to pool in the legs, forcing fluid from the veins into the tissues of the feet and ankles. The most common symptom of varicose veins and edema is the substantial pain experienced, as well as night cramps, numbness, tingling, the legs may feel heavy, achy. Symptoms tend to worsen after long periods of standing and with each successive pregnancy.
What can we do about it?
The swelling during pregnancy is not due to lymphedema but due to system overload. The lymphatic system works as a functional reservoir for the venous system, and edema occurs when the reserving capacity is exceeded. Edema in pregnancy is commonly treated with elevation of the feet and the use of compression stockings, but this is not always tolerated by pregnant women.
Manual lymph drainage is the most indicated treatment of edema. So why not use it as a treatment for leg edema in pregnant women? Manual lymph drainage is a gentle, non-invasive manual technique. If performed with the correct pressure, direction and speed, it has a powerful effect on the body. It can encourage lymph flow and thus facilitate drainage and favoring a reduction of edema.
In the study by S. Oportus et al, 15 women were treated in the 5th to 8th months of gestation for one hour of manual lymph drainage of the legs. Patients were evaluated for variations in edema and the effects of lymph drainage during the day. They were evaluated on two days, one when lymph drainage was performed and the other without lymph drainage. On comparing the mean volume on days without lymph drainage, with that when drainage was performed, there was a difference of about 80 grams. So, the study demonstrated that manual lymph drainage reduces limb volume in pregnant women.
At Emirates Integra, we can make the difference
I am qualified as a master in rehabilitation sciences and physiotherapy from Ghent University, Belgium with more than five years experience in hospitals and private practices in Belgium. I specialize in treating musculoskeletal conditions with a strong focus on exercise specific rehabilitation and pre/post-operative treatment.
With particular training in manual lymph drainage, also referred to as Lymphatic massage or lymphatic drainage, I provide great value in effectively responding to edema issues during pregnance. By stimulating contractions of lymphatic vessels, the manual work I conduct helps move extra fluid from an area that may be swollen to an area where the lymph nodes are working properly. Call me at Emirates Integra today!