Table: Some Causes and Features of Swelling During Late Pregnancy-Merck Manual Consumer Version

Some Causes and Features of Swelling During Late Pregnancy

Cause	Common Features*	Diagnostic Approach†
Normal (physiologic) edema	Painless swelling (edema) in both legs	A doctor’s examination
Preeclampsia	High blood pressure (140/90 mm Hg or higher) Swelling in both feet and ankles and sometimes in the face and/or hands Sometimes, severe persistent headache, confusion, problems with vision, severe upper abdominal pain, or difficulty breathing If very severe, seizures may occur Sometimes risk factors for preeclampsia	Measurement of blood pressure Measurement of protein in the urine Blood tests to check liver and kidney function and a complete blood count
Deep vein thrombosis	Swelling and pain in only one leg or calf Often tenderness, redness, and warmth in the affected area If a blood clot travels to the lungs and blocks a blood vessel there (causing pulmonary embolism), chest pain and difficulty breathing Sometimes risk factors for deep vein thrombosis	Ultrasonography of the affected leg to check for a blockage in the veins Sometimes a blood test to measure a substance released from blood clots (called D-dimer) If the woman has chest pain and difficulty breathing, sometimes CT of the chest or ventilation/perfusion (nuclear imaging test) lung scan
Peripartum cardiomyopathy	Swelling in both legs Shortness of breath and fatigue Difficulty laying flat	Chest x-ray Electrocardiography Echocardiography Blood tests that measure stretch in the heart
* Features include symptoms and results of the doctor's examination. Features mentioned are typical but not always present. † In pregnant women with concerning symptoms, the doctor assesses maternal vital signs, does a physical examination, and evaluates the status of the fetus with a fetal heart rate monitor or ultrasound.

Cause

Common Features*

Diagnostic Approach†

Normal (physiologic) edema

Painless swelling (edema) in both legs

A doctor’s examination

Preeclampsia

High blood pressure (140/90 mm Hg or higher)

Swelling in both feet and ankles and sometimes in the face and/or hands

Sometimes, severe persistent headache, confusion, problems with vision, severe upper abdominal pain, or difficulty breathing

If very severe, seizures may occur

Sometimes risk factors for preeclampsia

Measurement of blood pressure

Measurement of protein in the urine

Blood tests to check liver and kidney function and a complete blood count

Deep vein thrombosis

Swelling and pain in only one leg or calf

Often tenderness, redness, and warmth in the affected area

If a blood clot travels to the lungs and blocks a blood vessel there (causing pulmonary embolism), chest pain and difficulty breathing

Sometimes risk factors for deep vein thrombosis

Ultrasonography of the affected leg to check for a blockage in the veins

Sometimes a blood test to measure a substance released from blood clots (called D-dimer)

If the woman has chest pain and difficulty breathing, sometimes CT of the chest or ventilation/perfusion (nuclear imaging test) lung scan

Peripartum cardiomyopathy

Swelling in both legs

Shortness of breath and fatigue

Difficulty laying flat

Chest x-ray

Electrocardiography

Echocardiography

Blood tests that measure stretch in the heart

* Features include symptoms and results of the doctor's examination. Features mentioned are typical but not always present.

† In pregnant women with concerning symptoms, the doctor assesses maternal vital signs, does a physical examination, and evaluates the status of the fetus with a fetal heart rate monitor or ultrasound.