[34F] Pregnant woman with sudden pitting leg swelling and burning sensation

Patient Description

A 34-year-old female, currently 24 almost 25 weeks pregnant, reports sudden onset of pitting swelling in one leg and foot since yesterday morning. The swelling is not warm to the touch, but there is a burning sensation in the back of the calf and heel that feels like it's on fire. The patient experiences pain in the leg, especially when walking or standing. There is no recent injury, trauma, long travel, prolonged immobility, or history of blood clots. The patient denies shortness of breath, chest pain, and noticeable redness or discoloration in the swollen leg. She has not noticed any unusual fatigue beyond normal pregnancy fatigue and has no visible veins or varicose veins in the swollen leg. Medical history is unremarkable for heart disease, stroke, or autoimmune diseases. Current medications include prenatal vitamins (2 gummies daily) and Zofran (40mg as needed every 8 hours). The patient has allergies to erythromycin, amoxicillin, and penicillin. No recent changes in diet or fluid intake and no exposure to new environments or substances.

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Arora's Assessment

What might be happening

Based on the information you’ve provided, there are a few serious conditions that could be causing your symptoms:

  1. Deep Vein Thrombosis (DVT): This is a blood clot that forms in a deep vein, usually in the leg. Given the sudden onset of swelling, pitting edema, and burning sensation, DVT is a serious concern, especially during pregnancy, which increases the risk of blood clots. DVT can lead to life-threatening complications if the clot travels to the lungs (pulmonary embolism).

  2. Pre-eclampsia: This is a pregnancy complication characterized by high blood pressure and signs of damage to another organ system, often the kidneys. While you haven't mentioned high blood pressure, the sudden swelling in one leg could be a sign. Pre-eclampsia requires immediate medical attention.

  3. Cellulitis: This is a bacterial skin infection that can cause swelling, redness, and pain. Although you mentioned no warmth or redness, it’s still a possibility, especially if there’s an underlying infection.

  4. Venous Insufficiency: This occurs when the veins in your legs have trouble sending blood back to your heart. Pregnancy can exacerbate this condition, leading to swelling and discomfort.

What you can do

  1. Seek Immediate Medical Attention: Given the potential seriousness of your symptoms, it is crucial to seek medical attention immediately. Go to the nearest emergency room or urgent care center. If you are unable to get there yourself, call 911 or have someone drive you.

  2. Monitor Symptoms: While waiting for medical help, keep an eye on your symptoms. If you experience shortness of breath, chest pain, or the swelling worsens, inform the medical professionals immediately.

  3. Avoid Walking or Standing: Try to keep off your feet as much as possible to avoid aggravating the condition.

  4. Elevate Your Leg: If possible, elevate your leg above the level of your heart to help reduce swelling.

  5. Stay Hydrated: Drink plenty of water unless advised otherwise by a healthcare professional.

Remember, I am not a doctor, and this advice is based on the information you’ve provided. It is essential to get a formal diagnosis and treatment from a healthcare professional.

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2 mo ago

People Also Ask

What are the symptoms of Deep Vein Thrombosis (DVT) during pregnancy?

Symptoms of DVT during pregnancy can include sudden swelling in one leg, pain or tenderness in the leg, especially when standing or walking, a feeling of warmth in the affected leg, and changes in skin color such as redness. It's important to seek medical attention if you suspect DVT.

How can pre-eclampsia affect pregnancy and what are its warning signs?

Pre-eclampsia can lead to serious complications for both the mother and baby if not managed properly. Warning signs include high blood pressure, severe headaches, changes in vision, upper abdominal pain, and sudden swelling in the hands, feet, or face. Immediate medical evaluation is necessary if pre-eclampsia is suspected.

What are the common causes of leg swelling during pregnancy?

Common causes of leg swelling during pregnancy include increased blood volume, hormonal changes, pressure from the growing uterus on blood vessels, and reduced circulation. While some swelling is normal, sudden or severe swelling should be evaluated by a healthcare provider.

How can venous insufficiency be managed during pregnancy?

Venous insufficiency during pregnancy can be managed by elevating the legs, wearing compression stockings, avoiding prolonged standing or sitting, and staying active with safe exercises. It's important to discuss management strategies with a healthcare provider to ensure safety for both mother and baby.

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