The document discusses edema in pregnancy and gynecology. It notes that edema is usually physiological in pregnancy but can sometimes indicate pathological conditions that complicate pregnancy. By differentiating types of edema, doctors can diagnose high-risk pregnancies and save both mother and fetus. Edema in gynecology patients can be caused by pathological diseases like infections or malignancies. The document provides tips for managing edema and discusses edema in the context of preeclampsia, cancers, infections, and other conditions.

2.  In pregnancy, edema is physiological but sometimes it can indicate pathological
disease which can complicate pregnancy.
 By differentiating edema we can diagnose high risk pregnancy & we can save both
mother & fetus.
 In gynae patient edema can present as some pathological disease & also it
indicate prognosis of some disease & its treatment.

3. 1. Changes in maternal osmoregulation.
2. Increased estrogen-progesterone.
3. Increased RAAS activity.
4. Increased aldosterone deoxycorticosterone.
1. Increased plasma volume about 500 ml.
2. Increased estrogen-progesterone & all physiological process of pregnancy.
So, in multiple pregnancy the physiological edema in pregnancy is more
pronounced.

5.  Avoid long period of standing / sitting.
(Take a break & change of your posture)
 Stretch your legs / Exercise your legs.
 Diet-
a) High protein diet / Adequete amount of protein.
b) Low salt intake.
 Sleep on your side (preferably on your left side).
 Fluid restriction is not necessary.

6.  In obs:
o Vulver edema is normally present in pregnancy.
o It is more marked in eclampsia.
 In gynae:
o In infrectious condition like STD’s present vulvar edema.
o In some malignancy like ovarian malignancy and Ca cervix.

7.  In later pregnancy (after 28 weeks usually) excessive edema should be counted as
edema due to preeclamsia.

8. Preeclamsia
Increased
oxidative stress
Endothelial injury
Increase capillary
permeability
Decrease osmotic
pressure
Increased
oxidative stress
Increase ECF
volume
Increase salt
retention
Decrease GFR
Massive
protinuria
Decrease colloidal
osmotic pressure
Decrease colloidal
osmotic pressure
Edema

9. 1. Abnormal weight gain: Rapid weight gain like gaining >5lb in a month or 1lb in
a week in later pregnancy.
2. Hypertension: Rise of systolic BP >30 mmHg & diastolic BP >15 mmHg than
that of normal for that individual.
3. Proteinuria: Presence of total protein >300 mg in 24 hour urine sample.

12.  Edema in non pregnant female patients are mostly due to Hormonal cause.
 In gynecology we see mostly edema in
o Malignancy (Ovarian Ca, Ca cervix).
o Infections (STDs).

13.  Causes are
Lymphatic
obstruction
Stasis of
lymphatics
Increase
Hydrostatic
pressure
Escape of fluid
in interstitial
space
Aggravate
edema
Hepatic
metastasis
Portal
hypertention
Ascitis & edema
Decrease
Albumin
production
Decrease
colloidal osmotic
pressure
edema

14. Edema
Escape of
fluid from
blood vessels
Incrase
hydrostatic
pressure
Stasis of
blood
Decrease
venous
return
Compression
of tumor
mass over
inferior
vanacava
edema
Incrasse
hydrostatic
pressure
Incrase salt
water
retention
progesterone
Hormone
dependent
edema