Edema During Pregnancy: Normal or Cause for Concern?
Edema is a common phenomenon during pregnancy that most expectant mothers face. Often, it is physiological, meaning normal, and is associated with an increase in blood volume, hormonal changes, and the pressure of the growing uterus on blood vessels. Such swelling usually appears in the feet and ankles, worsens by the evening, and resolves after rest. However, there are situations when edema may signal more serious health issues requiring immediate attention. These conditions include preeclampsia—a dangerous pregnancy complication that can develop against the background of certain chronic conditions [5, 6].
It is important to distinguish between physiological and pathological edema. If the swelling is sudden, severe, spreads to the face and hands, and is accompanied by a headache, visual disturbances, or abdominal pain, it is a reason to seek immediate medical attention. In the context of systemic diseases such as rheumatoid arthritis and systemic lupus erythematosus, the risk of developing serious complications, including preeclampsia, increases significantly [5, 6].
Systemic Diseases and the Risk of Preeclampsia
Women suffering from systemic autoimmune diseases, such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), face unique challenges during pregnancy. These conditions can exacerbate during the gestational period, which in turn increases the risk of developing various complications [5, 6]. One of the most serious complications is preeclampsia. Preeclampsia is a condition characterized by high blood pressure, the presence of protein in the urine, and often pronounced edema, which can be generalized. It poses a threat to both the mother and the fetus, leading to premature birth or fetal growth restriction [5, 6].
Studies show that flares of RA and SLE during pregnancy can directly contribute to the development of preeclampsia. Therefore, it is critically important that women with these diagnoses are closely monitored by specialists and receive adequate treatment to control their underlying condition [5, 6].
Management of Chronic Conditions for the Prevention of Complications
A key aspect of successful pregnancy management in women with rheumatoid arthritis and systemic lupus erythematosus is achieving disease control even before conception. Specialists emphasize that the disease should be in remission or have minimal activity prior to pregnancy in order to minimize risks to the mother and fetus [5, 6].
During pregnancy, the management of these conditions requires a specialized approach. Many, but not all, antirheumatic drugs can be safely used during pregnancy and breastfeeding. The choice of therapy should be made jointly by a rheumatologist and an obstetrician-gynecologist, taking into account individual risks and benefits. The goal of treatment is to prevent flares that can lead to complications such as preeclampsia and, consequently, pathological edema [5, 6]. Effective control of the underlying disease is the primary strategy for preventing its complications.
Prevention of Thrombosis in Antiphospholipid Syndrome
Another important aspect of pregnancy management related to systemic diseases and the risk of complications is obstetric antiphospholipid syndrome (APS). This is an autoimmune disease in which the body produces antibodies against phospholipids, leading to an increased risk of blood clots. In women with obstetric APS, the likelihood of developing thrombosis during pregnancy increases significantly, as do complications such as recurrent miscarriage, premature birth, and preeclampsia [5, 6].
To prevent these serious conditions, women with APS require anticoagulant therapy throughout their pregnancy. The use of anticoagulants helps reduce the risk of blood clot formation and improves pregnancy outcomes [5, 6]. This is a critically important preventive measure aimed at protecting the health of both mother and child.
Comprehensive Approach and Interdisciplinary Monitoring
Managing pregnancy in women with systemic diseases requires close cooperation between various specialists. Obstetrician-gynecologists, rheumatologists, and other subspecialists must work as a team to ensure a comprehensive and individualized approach for each patient. Regular monitoring, careful observation of the mother and fetus, and timely adjustment of therapy help minimize risks and prevent the development of serious complications, including pathological edema, preeclampsia, and thrombosis [5, 6].
Achieving control over the underlying disease before conception and maintaining it throughout pregnancy is the key to a successful outcome. This interdisciplinary approach ensures not only the safety of the mother but also the favorable development of the fetus, significantly improving prognoses for women with chronic autoimmune diseases.
Sources
- 1. Management of severe eczema in pregnancy. (2025). https://pubmed.ncbi.nlm.nih.gov/39733910/
- 2. Dermatologic treatment during pregnancy: a practical review. (2006). https://pubmed.ncbi.nlm.nih.gov/17234117/
- 3. Teratogenic effect of an unregistered traditional Chinese medicine containing Atractylodis lancea radix, Glycyrrhiza glabra radix, Rheum officinale rhizome, and Angelica dahurica radix on the fetal morphology of BALB/c mice. (2025). https://pubmed.ncbi.nlm.nih.gov/40839075/
- 4. Infant skin care interventions for preventing eczema and food allergy. (2022). https://pubmed.ncbi.nlm.nih.gov/36373988/
- 5. Pregnancy and management of women with rheumatoid arthritis, systemic lupus erythematosus, and obstetric antiphospholipid syndrome. (2021). https://pubmed.ncbi.nlm.nih.gov/33589107/
- 6. Pregnancy and management of women with rheumatoid arthritis, systemic lupus erythematosus, and obstetric antiphospholipid syndrome. (2022). https://pubmed.ncbi.nlm.nih.gov/35400376/
- 7. Toronto consensus statements for the management of inflammatory bowel disease in pregnancy. (2016). https://pubmed.ncbi.nlm.nih.gov/26688268/
- 8. No. 285-Toxoplasmosis in pregnancy: prevention, screening, and treatment. (2018). https://pubmed.ncbi.nlm.nih.gov/30103893/
Disclaimer: The information provided in this article is for reference purposes only and cannot replace an in-person consultation with a qualified medical professional. Always consult a physician for diagnosis and treatment.