Swelling in your legs and feet is common, especially
when the day is over. A serious complication is a
blood clot of the legs or groin. Symptoms are swelling
of the legs accompanied by leg pain and redness or
warmth in the affected area. This problem has many
names including venous thrombosis, thromboembolic
disease and lower deep vein thrombosis (DVT). It may
happen at other times as well but pregnancy is a time
when it is more rampant. This is due to the weight
of the uterus and changes in the blood and its clotting
mechanisms.
The decrease in blood flow is called stasis. If you
had a clot before in your legs or anywhere else, inform
your doctor on this vital information. There is a
difference between DVT and superficial thrombosis.
The latter is often at the surface of the skin and
can be felt on the surface; it is treatable with a
mild pain reliever, elevation of leg, support stockings
and heat. If condition does not improve DVT must be
considered. This is a more serious condition; it requires
diagnostic procedure and treatment.
Symptoms can differ depending on the location and
severity. The onset can be rapid with severe pain
and swelling of the leg and thigh. Inform your doctor
early on in pregnancy about previous clots. The greatest
danger is pulmonary embolism in which the clot breaks
off and travels from the legs to the lungs. It is
a rare problem and although it is serious it is preventable.
The leg may occasionally appear pale and cool but
the affected portion is tender, hot and swollen. Often
the skin is red; squeezing the leg or calf area is
painful and walking only aggravates the pain. One
way to tell if you have this problem is to lie down
and flex your toes toward your knee. If you feel tenderness
at the back of the leg, then it is an indication that
you have this problem. Check with your doctor if this
occurs.
In the non-pregnant woman diagnosing the problem can
be done via an X-ray accompanied by an injection with
dye into leg veins to detect the clots. This test
is not usually performed on a pregnant woman because
of exposure to radiation and dye; ultrasound is used
instead. Treatment involved hospitalization and heparin
therapy, where heparin a blood thinner is administered
intravenously. It can be taken in the form of a pill.
It is safe during pregnancy and is not passed on to
the baby.
Extra calcium must be taken if heparin is given. Mother
must be in bed with the leg elevated and heat applied.
Mild pain reliever is given. Recovery including hospitalization
ranges from 7-10 days. Heparin is given after this
until delivery; following pregnancy she may have to
continue with the therapy depending on the severity
of the clot. If a woman has clot problems in one pregnancy,
it is likely that she will need therapy in subsequent
pregnancies. Heparin can be given through daily self-administered
injections or in-dwelling IV catheter under doctor's
advice. There is an alternative treatment, but that
is not advisable as it passes through the placenta
and can be harmful to the baby. This oral medication
can be given post pregnancy to prevent blood clots
for weeks to months depending on the severity.
