What causes ankle swelling during pregnancy — and what can I do about it?
Answers from Roger W. Harms, M.D.
Various factors contribute to foot and ankle swelling during pregnancy. For starters, your body produces and retains more fluid during pregnancy. Also, your growing uterus puts pressure on your veins, which impairs return of blood to your heart. In turn, this can lead to swelling in the legs, ankles and feet. Hormonal changes might play a role as well.
Foot and ankle swelling during pregnancy is common and usually goes away after delivery. In the meantime, it might help to:
- Stay off your feet. Avoid standing for long periods, and don't cross your legs. When you can, sit with your feet up and occasionally rotate your feet at the ankles. Better yet, lie down with your legs elevated.
- Sleep on your side. If you can, sleep on your left side. This takes pressure off the inferior vena cava — the large vein that returns blood from the lower half of your body to your heart. It also might help to elevate your legs slightly with pillows.
- Wear compression stockings. Your health care provider might recommend wearing supportive tights or stockings.
- Drink plenty of fluids. The Institute of Medicine recommends about 10 cups (2.3 liters) of fluids a day during pregnancy.
- Include physical activity in your daily routine. Take daily walks, ride a stationary bike or swim laps in a pool.
- Stand in the pool. Although there's little research on the use of water pressure for foot and ankle swelling, standing in a pool seems to help compress tissues in the legs and might provide temporary relief from swelling during pregnancy.
- Stay cool. It might be soothing to apply cold-water compresses to swollen areas.
In addition, some research suggests that regular foot massages might help decrease foot and ankle swelling during pregnancy.
Although mild foot and ankle swelling during pregnancy is normal, extreme swelling during pregnancy can be a red flag. Contact your health care provider if you have:
- Severe or sudden swelling
- Swelling in only one leg
Severe or sudden swelling could be a sign of a serious condition called preeclampsia. Other signs and symptoms of preeclampsia include severe headaches, blurred vision and rapid weight gain. Swelling in only one leg — especially if it's accompanied by pain or tenderness in the calf or thigh — could indicate a blood clot or other underlying condition. Both conditions warrant prompt evaluation and treatment.
Sep. 10, 2011
- Ponnapula P, et al. Lower extremity changes experienced during pregnancy. The Journal of Foot and Ankle Surgery. 2010;49:452.
- Bamigboye AA, et al. Interventions for varicose veins and leg oedema in pregnancy. Cochrane Database of Systematic Reviews. 2007:CD001066. http://www2.cochrane.org/reviews/en/ab001066.html. Accessed July 12, 2011.
- August P, et al. Clinical features, diagnosis, and long-term prognosis of preeclampsia. http://www.uptodate.com/index. Accessed July 12, 2011.
- Exercise during pregnancy. American Congress of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp119.cfm. Accessed July 12, 2011.
- Coban A, et al. Effect of foot massage to decrease physiological lower leg oedema in late pregnancy: A randomized controlled trial in Turkey. International Journal of Nursing Practice. 2010;16:454.
- Seller RH. Differential Diagnosis of Common Complaints. 5th ed. Philadelphia, Pa.: Saunders Elsevier; 2007:363.
- Dietary Reference Intakes for water, potassium, sodium, chloride and sulfate. Institute of Medicine. http://www.nal.usda.gov/fnic/DRI//DRI_Water/73-185.pdf. Accessed July 18, 2011.
- Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. July 19, 2011.
- Murry MM (expert opinion). Mayo Clinic, Rochester, Minn. July 20, 2011.