gynecology and obstetrics
Lower Extremity Edema During Late Pregnancy
Key Points
Edema is common and usually benign (physiologic) during late pregnancy. Physiologic edema is reduced by lying in the left lateral decubitus position, elevating the lower extremities, using compression stockings, and wearing loose clothing that does not restrict blood flow. New-onset hypertension and proteinuria indicate preeclampsia; absence of proteinuria does not exclude preeclampsia. Evaluate patients for DVT if they have unilateral leg edema, redness, warmth, and tenderness. Evaluate patients for peripartum cardiomyopathy if they have dyspnea and if the physical examination detects evidence of fluid overload. Because preeclampsia significantly increases the risk of peripartum cardiomyopathy, rapidly evaluate patients who have preeclampsia and possible cardiac dysfunction and/or pulmonary edema for peripartum cardiomyopathy. 