Edema During Pregnancy

SYMPTOMS AND SIGNS: Edema appears on the face, on the four limbs and/or other parts of the body during pregnancy, accompanied with other symptoms, such as poor appetite, sour and weak feeling at lumbar region, dizziness, full and suffocating sensation of chest and gastric region. Pale tongue, weak or deep thready pulse. 

ETIOLOGY AND PATHOLOGY: Edema during pregnancy is usually due to spleen and kidney Yang deficiency body types. When a woman is pregnant, all Yin and blood go to nourish the uterus which will further obstruct the functions of spleen and kidney, thereby causing the retention of water or fluids. Moody emotions during pregnancy also lead to liver Qi stagnation, which will also obstruct the transportation and distribution of body fluids and water metabolism. 

DIFFERENTIATIONS: 

1. Edema of Pregnancy due to Spleen Deficiency:

Indications: Edema on face and four limbs, or gradually shows on the whole body, whitish or dull looking skin, oppression and full feeling at chest. shortness. of breath dislikes talking, tasteless mouth, poor appetite, loose  tool. Pale and enlarged tongue, white and thin coating, or thin and greasy coating with teeth marks on the sides of tongue, slow and slippery pulse. 

Treatment & Formulas: Regulate the water metabolism by promoting the functions of spleen. 

Products:

    • Bu Zhong Yi Qi Tang (Ginseng and Astragalus Combination, Item No. 2225): Fu Ling (Poria Cocos, Item No. 1133) may be added to strengthen its function of regulating the water retention. 
    • Wu Pi Yin (Hoelen and Areca Combination, Item No. 2042): This is a very good formula to treat edema due to water or damp retention and spleen deficiency. 

2. Edema of Pregnancy due to Kidney Deficiency:

Indications: Edema of face and four limbs, especially at lower part of legs, skin does not recover quickly after being pressed, palpitation, shortness of breath, sore and weak feeling at lumbar region, pale tongue, white and moisture coating, deep and thready pulse.

Treatment & Formulas: Tonify kidney and promote water metabolism.

Products:

    • Zhen Wu Tang (Vitality Combination, Item No. 2170): This is a typical formula to promote the water circulation by tonifying the kidney Yang. 
    • Wu Ling San (Hoelen Five Herb Formula, Item No. 2043): This is a diuretic formula by promoting the functions of kidney and spleen. It also can be combined with Zhen Wu Tang. 
    • Ji Sheng Shen Qi Wan (Achyranthes and Plantago Formula, Item No. 2263): This is a very good formula to tonify the kidney Yang, at the same time it has the function of diuresis. So it is very often used for edema due to kidney Yang deficiency. 

3. Edema of Pregnancy due to Qi Stagnation:

Indications: Edema from feet, then to legs, there is not any change of skin color, skin recovers to normal immediately after pressing, dizziness, fullness and pain at chest and gastric regions, poor appetite. Thin and greasy tongue coating, wiry and slippery pulse.

Treatment & Formulas: Regulate the Qi and promote the functions of spleen and fluid circulation.

Products:

    • Xiao Yao San (Tang - kuei and Bupleurum Formula Item No. 2195): This is a typical formula tr Qi regulating and harmonizing. It also can be combined with Wu Ling San to strengthen the function of diuresis.  

COMMENTS: 

1. If the abdomen appears to be an extraordinary large size (more than the uterus real size according to the month of pregnancy), then is mostly due hydramnios. Symptoms show general edema, or edema of lower legs and vulva, shortness of panting, palpitation, full and suffocating sensation of chest and abdomen, purplish lips and cheeks urine, pale tongue, thin and moisture coating, deep and slippery pulse. Zhen Wu Tang (Vitality Combination) can be used. Fish soup is highly recommended.

2. If edema shows at the seventh or the eighth month of pregnancy without other accompanied symptoms, it does not need medication, and will disappear soon after the baby is born. 


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