Pregnancy edema
Pregnancy edema is a physiologic response to pregnancy-induced increased estrogen formation. Such hormonal changes lead to altered composition of the intercellular substance of connective tissue. As a result, fluid accumulation in the connective tissue occurs. Frequently, pregnant women who are sitting or standing experience changes in blood pressure in the capillaries of the lower extremities (cardiac edema). The impaired capillary permeability during pregnancy also leads to fluid accumulation in the hands and face, causing these areas to swell easily. If a pregnant woman takes in too little protein through food or if increased excretion occurs, the oncotic colloid osmotic pressure decreases, which also leads to increased water retention in the tissues (hypoproteinemic edema). Especially toward the end of pregnancy, venous pressure, oncotic pressure, hydrostatic pressure, and capillary permeability increase. Thus, the risk of local edema occurring in position-dependent parts of the body increases. The course of pregnancy and fetal development are not adversely affected by edema formation. Furthermore, due to renal as well as vascular dysfunction, increased protein excretion with the urine and high blood pressure (hypertension) occur. Depending on the severity, such dysfunctions may increase the viscosity of the blood. Consequently, to ensure blood supply to the fetus, the blood must be diluted (hemodilution). Finally, gestational gestosis describes the symptoms of edema, protein excretion, and hypertension that are common during pregnancy. Risk factors, such as age, maternal pre-existing conditions – kidney disease, hypertension, diabetes mellitus -, psychosocial factors, low social status and occupational stress increase the risk of developing gestosis. As a preventive measure, a diet rich in unsaturated fatty acids – weekly consumption of cold–water fish, such as mackerel, herring, sardines, salmon and trout – is recommended. In addition, the daily diet should be varied and of high quality – foods with high nutrient and vital substance density (macro- and micronutrients) such as whole grains, potatoes, vegetables, fruits, fruit juices, milk and dairy products, and meat. Eating more frequent and smaller meals while drinking plenty of fluids prevents cravings as well as blood sugar fluctuations.
Protein excretion and hypertension
Due to renal as well as vascular dysfunction, increased protein excretion with urine and high blood pressure (hypertension) occur. Pregnancy-related hormonal changes – increased estrogen formation – lead to an altered composition of the intercellular substance of the connective tissue. As a result, fluid accumulates in the connective tissue (edema formation). If pregnant women exhibit arterial hypertension, protein loss and a tendency to edema at the same time, gestosis (toxicemia) is present. Both too much and too little weight gain, as well as salt deficiency, can increase the risk of hypertension during pregnancy. If too little zinc and calcium is supplied to the maternal organism, the risk of gestosis may increase. In order to avoid pregnancy hypertension and gestosis, pregnant women should pay attention to a balanced diet – divided into six portions daily – and avoid salt deficiency and too much or too little weight gain. In particular, the vital substances (micronutrients) calcium and zinc should not be missing from the diet, since in sufficient quantities they can reduce the risk of toxemia by almost 50%. Additional B vitamins and evening primrose oil – gamma-linolenic acid – also do a good job in preventing and treating toxicemia. Detailed information on the topic of “High blood pressure in pregnancy” can be found in the chapter on “Gestosis”.
