Aboutновление: Октябрь 2018
Edema во время беременности встречаются в той или иной степени
almost every woman. But не во всех случаях они
indicate pathology and require medical treatment.
Before you begin to treat edema, you should identify the cause of their
whether it is necessary to eliminate edema, and whether
fighting them worse.
ATода как необходимый элемент беременности
how известно, человеческий организм до 80% состоит из воды. ATо
time of gestation, the amount of water increases by 6 – 8
liters, most of which (up to 6 liters) is in
extra-tissue state, and about 3 liters accumulates in the tissues. TO
the end of gestation, the volume of water increases by another 6 liters, 3 of them
fall on the baby, the placenta and the amniotic fluid, and the rest on
an increase in the circulating blood of a woman, a growing uterus and
mammary gland. This “flood” is a normal condition.
physiologically proceeding pregnancy.
ATозрастание объема жидкой части крови начинается с 8 недель,
whereas an increase in the number of red blood cells from 18 weeks. it
due to the need to deliver oxygen and nutrients
the fetus – the thinner and fluid the blood, the faster it performs
Education mechanism отеков
For water to flow to the fetus, it must be in the vascular
русле, а не в тканях или полостях body. Fluid in the blood vessels
retain 2 components:
- sodium chloride
- protein (albumin).
Albumin protein maintains oncotic pressure in the blood
vessels, and sodium retains water in them. If there is a shortage
these substances, the liquid “leaves” in the tissue, that is, it is noted
повышенная проницаемость vessels. Albumin produces liver
women from those amino acids that come from food, that is
it matters how the expectant mother feeds.
Sodium chloride comes from food and is also saved by the kidneys.
TOроме того, солевой обмен регулируется гормонами. In this way,
there is a second point in the mechanism of edema – a violation
water-salt metabolism when sodium accumulates in the tissues and
притягивает воду из vessels. Since the liquid part of the blood becomes
little, then there is its thickening, that is, against the background of visible or
hidden edema mother’s body is dehydrated
Edema могут быть как физиологическими, то есть те, которые
pass independently when eliminating provoking factors and
pathological, due to any medical problem.
The edge separating the edema into “normal” and pathology is rather unsteady,
and it is very difficult to carry out, and not only the term should be considered
gestation and concomitant pathology, but also the woman’s age,
the amount of bearing fruit, its growth and constitutional
Also, swelling is classified by their prevalence:
- I degree – swelling of the legs (most often the feet and legs) and hands
- Grade II – swelling “rises” on the front wall of the abdomen and
- Grade III – not only the lower limbs and the stomach swell, but also
- IV degree – generalized edema or anasarca.
AT зависимости от происхождения отеки делят на:
- hydremic – due to urinary disorders
- cardiac arising from cardiovascular
- cachectic or dystrophic due to exhaustion;
- inflammatory result from the formation of a lesion
inflammations (traumatic, allergic, neurotic and
- congestive swelling occurs in diseases of the veins (varicose veins
disease, thrombosis and thrombophlebitis).
Withчины появления отеков
Physiological edema могут появляться по следующим
- hot and sultry weather;
- excessive exercise on the legs (prolonged standing,
walking) or on your hands (working at a computer, writing);
- flat feet;
- wearing tight shoes or high heels;
- long sitting on soft and low seats;
- the habit of crossing legs when sitting;
- errors in diet (excessive consumption of salty and spicy
- a large volume of the uterus (in the later stages of gestation or during
polyhydramnios and polyplodia) – the uterus squeezes the inferior vena cava and
disrupts blood flow in the lower body and legs;
- short stature;
Pathological edema occurs in the presence of a number of diseases
and / or as a complication of pregnancy:
ATарикозная болезнь нижних конечностей
AT данном случае отеки появляются вследствие нарушения оттока
blood flow through the veins, its stagnation in the veins, which provokes an increase in
hydrostatic pressure in them. First, the pressure increases in
large venous vessels, and then in small, and occurs
�”Squeezing” of fluid from vessels into the interstitial space with
the formation of edema. TO этой же группе относятся и другие
venous diseases that can be a complication of varicose veins
diseases as well as an independent disease (thrombosis, phlebitis,
thrombophlebitis). AT данном случае помимо описанного механизма
developmental edema present and inflammatory moment.
Heart diseases (congenital heart defects, myocarditis and
other) lead to the development of cardiovascular failure, one
of the manifestations of which are swelling. Fluid retention
due to increased central venous pressure, since
internal organs receive less blood enriched with oxygen, and
also sodium retention by the kidneys. With увеличении центрального
venous pressure increases hydrostatic pressure in
capillaries that “squeezes” water into the tissue. Pregnancy
increases the load on the work of the heart, which further conditions
the occurrence of edema.
Nephrotic syndrome, which is characterized by edema, as
usually observed with glomerulonephritis. Education mechanism
Edema has a few points. ATо-первых, белок теряется с мочой
against the background of normal or frequent urination, which leads to
reduce oncotic pressure in blood vessels and increase
their permeability, and, consequently, the occurrence of edema.
ATо-вторых, при уменьшенном мочеиспускании происходит задержка
sodium in tissues, which draws fluid from the blood
vessels. AT-третьих, нарушается фильтрационная функция почек
(sodium retention) and the water-salt metabolism is disturbed (increases
production of aldosterone, which also retains fluid in
Quincke edema is one of the most severe manifestations of allergies associated with
generalized puffiness of the upper respiratory tract mucosa and
skin and develops on the penetration of the allergen (antigen)
into the body. Allergen contributes to the development of inflammatory mediators:
serotonin, histamine and others. AT свою очередь медиаторы воспаления
increase the permeability of the vascular wall and fluid from the blood
rushes into the tissue, forming swelling. More about swelling
The mechanism of development of this complication of pregnancy and edema in
Particularly difficult. ATозникновение отеков связано,
Firstly, with the loss of protein in the urine and a decrease in oncotic pressure
in the vessels. ATо-вторых, со спазмом сосудов (повышение артериального
pressure) and impaired microcirculation, which leads to an increase in
vascular permeability. And, thirdly, in the tissues
sodium is delayed, which “pulls” the liquid from the vessels to itself.
Читайте о гестозе при беременности.
Read about the symptoms of thyroid disease.
how определить отеки
Отек, по определению – это накопление избыточного
the amount of fluid outside the vascular bed, and tissues and cavities
internal organs (heart bag, pleural and other). Edema
divided into hidden and visible. Hidden edema may be suspected
Only a doctor based on the following symptoms:
A pregnant woman has a pathological weight gain, which
after 30 weeks is more than 300 grams in 7 days. Or shared
weight gain over the entire gestation period is more than 20 kg. but
the type of constitution and the height of the woman should be taken into account
pathological weight gain occurs due to hidden edema or
due to the accumulation of subcutaneous fat.
For its determination, the amount drunk is taken into account (along with
soups and watery fruits) and excreted fluids. AT норме их
the ratio is 4/3 (with about 300 ml of liquid
excreted with sweat and breath). If daily diuresis is negative,
that is, the amount of fluid consumed significantly exceeds the volume
selected, this indicates hidden edema.
A woman notes that the amount of urine released at night is much larger.
daytime. Withчем, позывы к мочеиспусканию по ночам учащаются. But
It should be remembered that after 37 weeks this symptom may
testify and about the upcoming birth (head pressed to
the entrance to the small pelvis and squeezes the bladder).
Probe Mac Klura – Aldrich
ATнутрикожно в область предплечья вводится 0,2 мл
saline sodium chloride and the time is trapped
resorption of the formed blister. AT норме он должен исчезнуть
after 35 minutes or more. If its resorption time is shortened,
You can safely talk about hidden edema.
ATидимые отеки может определить сама беременная на основании
the following symptoms:
- The symptom of the ring – on the swelling of the fingers shows characteristic
Sign: a wedding ring is not removed from the finger or removed from
- Aboutувь — привычная и разношенная обувь вдруг становится тесной и
presses that says about the swelling of the feet.
- Butски — после того, как будущая мама сняла носки, она замечает
that marks, even the pronounced impressions of their elastics on their feet, are long
do not fade.
- Symptom “pits” – when pressing a finger on the lower leg (in place
where only the skin covers the tibia) remains
characteristic recess that does not pass some time.
- Aboutъем голеностопного сустава — при измерении окружности в
ankle area and increasing it by 1 cm or more per week
speaks in favor of edema.
- Withзнаки генерализованного отека — при анасарке отекают не
only the legs, they are joined by swelling of the hands, labia, front
abdominal wall and face (swollen lips, eyelids and nose). Dangerous symptom –
impossibility to make a fist or to bend and fasten
footwear. Such strong swelling during pregnancy can
to testify to the developed preeclampsia.
Symptoms of different types of edema
Edemas of different origin are different and symptoms:
Edema in the early stages begins with the legs, extending to
hips and up, symmetrical. Upright body swelling
only legs. In a horizontal position, edema is redistributed to
sacrum and lower back, after sleep (in early stages) disappears. Edema
sufficiently dense, “pits” do not disappear for a long time. Skin
integuments in the area of edema blue and cold. Later to edema
subcutaneous tissue joins accumulation of fluid in the cavities
(pleural, cardiac, abdominal). In addition, dyspnea occurs,
tachycardia, fatigue and general pallor.
For the edema of renal origin is characterized by their appearance
above, and they spread down. Such swelling, on the contrary,
appear in the morning, and in the evening pass. They are loose and short
keep track of pressure. Appear on the face where more
loose subcutaneous tissue – swollen eyelids. Edema отличаются
propensity to migrate – move easily when changing position
body. The skin in the places of edema is pale, warm and dry. Have a place and
other symptoms: headaches, high blood pressure, urine
acquires the color of “meat slop” (gross hematuria).
Edema при заболеваниях вен нижних конечностей
With varicose disease of the lower extremities edema develops
gradually and associated with a long stay in the vertical
position Swelling appears in the evening, accompanied by a feeling
severity, redness of the feet, swollen veins, pain may occur.
The skin over the edema is warm, sometimes with a cyanotic hue. how
As a rule, such edemas are not symmetrical (they appear only on one
leg). In the case of thrombophlebitis, edema is accompanied by inflammatory
signs: hyperemia, fever, soreness along the vein, as well as
when moving or touching.
Usually their severity is insignificant, appear more often on
shins or fingers of hands (after long work). Pass
independently, after sleep and exclusion of provoking factors.
Edema при гестозе всегда начинаются со ступней и лодыжек (в
in some cases, the fingers “swell up” simultaneously. With deterioration
conditions of swelling rise and spread to the hips, genital
lips, front wall of the abdomen. Above pubis appears testovataya
pillow that makes it difficult or impossible to bend forward
(tie shoelaces). Then the swelling of the face joins, his features
coarse, eyes look like chinks due to swollen eyelids. After sleep
visible swelling “disappear” – redistributed throughout the body. Even
significant swelling accompanied by a satisfactory condition
pregnant, but nevertheless, require treatment. Prognostic
adverse symptoms are increased arterial
pressure (especially diastolic) and the appearance of protein in the urine.
Measures to combat edema
What to do if there are swelling during pregnancy. AT
the first thing to put aside panic and calm down. With small
physiological edema can be managed independently, but in
In case of significant or permanent edema, refer to
a doctor who tells you how to get rid of edema:
AT питании рекомендуется ограничить потребление поваренной соли
(but not excluded at all). Fluid intake of at least 2 – 2.5
liters a day in small sips and constantly. Of drinks
preference for herbal teas with sedative effect
(mint, chamomile, lemon balm), mors and non-carbonated mineral
It is recommended to make regular walks for 1.5 – 2 hours.
unhurried pace in the forest park area, which will help disperse
�”Stagnant” blood, will raise the general tone and prevent not only
the appearance of excess body fat, but also swelling.
Herbs with a diuretic effect
Broths and infusions of medicinal herbs with a weak diuretic effect
appointed by a doctor only. Especially their reception is shown at
diseases of the urinary system. To similar healing
Plants include: bearberry, lingonberry leaf, parsley. They
have weak diuretic, anti-inflammatory and
antispasmodic properties. Take care when swelling,
caused by preeclampsia (in this case, diuretic drugs
Drugs that increase vascular tone
Remove swelling (especially for diseases of the veins of the lower extremities)
local anticoagulant and vascular wall strengthening will help
means (list of anticoagulants). Similar drugs
prescribed by a doctor. It is allowed to rub into the skin of the feet Lioton-gel,
ATенитана, гепариновой мази, Эссавен геля. Also recommended
oral ascorutic, escuzane, venorouton, which
strengthen the vascular wall and reduce its permeability.
Wearing compression underwear
Removing swelling during pregnancy will help and wearing special
compression underwear (stockings or tights), which is especially
recommended for pregnant women with varicose legs. Put on
stockings / pantyhose must be lying down to evenly
distribute pressure to the lower limbs.
- Avoid being in hot places.
- Avoid prolonged standing or sitting.
In severe condition in the case of preeclampsia or worsening
chronic extragenital diseases (pathology of the kidneys, liver,
heart), pregnant hospitalized.
ATопрос – ответ
I swell (during pregnancy). What exactly is possible and impossible
It is recommended to exclude strong tea from drinking (including
green) and coffee, which are stimulating and provoke
the appearance of edema, as well as sugary fizzy drinks and juices
(cause thirst). Refusing to consume salt should not be, but
it is necessary to exclude, or at least limit the use of highly salted,
spicy and pickled foods (pickled cucumbers, sauerkraut,
nuts and chips and more). Follow the rules of healthy eating,
refuse to accept smoked meats, sweets and pastries. Food
it is advisable to steam, simmer, bake or boil, but not
In no case do not fry. AT суточном рационе должно содержаться
enough protein, both animal and vegetable
origin (lean meat, offal, cottage cheese, cereal cereals).
Also daily consume fresh vegetables and fruits, as sources
vitamins, and lactic acid products – a source of calcium. Useful
fish and seafood, vegetable oils, which contain
a large amount of polyunsaturated fatty acids.
What are dangerous swelling during pregnancy?
Any swelling, if, of course, they are not physiological, pose a threat
not only for a woman, but also for her future baby. About
extragenital pathology, women are usually known before
pregnancy, on the eve of and during which she was carrying
appropriate treatment is prescribed. Serious complication
Pregnancy are edema provoked by preeclampsia. With
absence of treatment may develop pre-convulsive state
(pre-eclampsia) and convulsive seizure (eclampsia). Withзнаками
preeclampsia serve as confusion or agitated
condition, swelling of the nose during pregnancy, which manifests itself
congestion or a sudden runny nose, flashing flies
before the eyes, tinnitus and so on. Not rendered timely
help leads to convulsions that can end in death
how в домашних условиях можно купировать отеки?
Minor edema of physiological origin will help
eliminate the following measures:
- supine position on the left side (decreases uterine pressure on
large blood vessels, improves blood circulation in the kidneys);
- sleep or rest with raised legs (put under them
a small pillow);
- cool foot baths, rubbing your feet with cubes
- gymnastics and foot massage;
- give up heels, preferring shoes on a small
heeled and loose;
- with a long forced position (sitting at the written
table) rest legs (lift them to a chair, walk a few
- avoid wearing tight and tight clothes (elastic bands, belts,
tight collars and socks).
how узнать, вхожу ли я в группу риска по развитию отеков и
AT данную группу входят беременные с имеющимися факторами:
- young (younger than 17) and late (over 30) age of a woman;
- preeclampsia during past pregnancies (especially
eclampsia and preeclampsia), blistering;
- pregnancy is not one fetus;
- the presence of hypertension before pregnancy;
- bad habits (both before and during pregnancy);
- diabetes and other endocrine pathology;
- pronounced early toxicosis;
- the presence of occupational hazards;
- revealed hidden edema.