31 yr G3P2 at 34 weeks & blood pressure records at home of 100-110/ 60-70mm Hg with complains of bilateral pedal edema & mild calf pain at night. Urine Dipstick shows trace protein, On examination , there is pitting edema of both legs without any calf tenderness. what is the best advice to this patient ?
Increased fluid retention manifested by pitting edema of the ankles and legs is a normal finding in pregnancy. Due to drop in colloid osmotic pressure and a fall in plasma osmolality with an increase in venous pressure created by paial occlusion of the vena cava by the gravid uterus contributes to pedal edema. Lasix is mostly avoided in pregnancy until in the acute setting to treat pulmonary edema. Trace protein in the urine is common in normal pregnancies and is not of concern. Doppler studies of the lower extremities are not indicated in an obvious physiologic edema here.
Prescribe Lasix (Frusemide) to relieve the painful swelling
Do a venous Doppler studies done to rule out deep vein thrombosis
Admit the patient and investigate to rule out pre-eclampsia
Reassure the patient that this is a normal finding of pregnancy
Obstetrics