Toxemia Concerns: What About This Swelling and Can Avoiding Salt Help?

I have had very swollen feet since about my 18th week. My doctor says to keep my feet elevated, avoid salt and drink lots of water. Is avoiding salt going to help me from getting toxemia or is it just to help keep the swelling down? Is the swelling harmful? Can I have toxemia and not have protein in my urine or high blood pressure?

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Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

How wise of you to question all of this. You are correct that avoiding salt will not prevent toxemia; in fact, this is bad advice to give to a pregnant woman unless heart disease or congestive heart failure has been documented. You may consider not using an excess of salt, and avoid such foods as bacon, cured meats and chips, but we should all avoid these foods!

Edema can be normal in pregnancy, but it can also serve as a red flag. If you were my client, I would tell you to increase fluids, rest on your left side at lunch time to help mobilize the fluid, keep your feet up whenever possible and have your blood pressure checked at least twice per month. Edema in the feet is not harmful. During hot weather, we often see swelling in the feet and lower leg. If the edema extends to the face or if you develop protein in the urine or experience headaches, upper abdominal pain or visual disturbances, call your care provider immediately and get tested for pre-eclampsia.

Remember, too, that the blood pressure does not have to reach abnormally high levels to indicate pre-eclampsia; if it increases by 30 mm (systolic -- top number) and/or 15 mm (diastolic -- bottom number), that is enough to warrant concern. So if you started care with a blood pressure of 90/60, readings of 120/75 later on are abnormal.

I wonder if your provider is a bit out of date. You could encourage him or her to run a Medline search for some recent information on pre-eclampsia and HELLP syndrome.

Good luck.

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