White legs in pregnancy

It is usually seen during last part of pregnancy, known as the third trimester of pregnancy. During this phase of pregnancy, the uterus becomes large and puts pressure against the hip bones. As a result, blood flow from the lower limbs to the heart via femoral vein is decreased, leading to an abnormal state called stasis. Femoral vein is the most important vein of the lower limbs. If the condition persists for a long time, thrombosis may develop leading to white legs in pregnancy. This is a treatable condition if it is diagnosed at an early stage and properly managed by a specialist doctor.

Signs and symptoms
The presenting symptoms of white legs include pain, white patches, and edema. The term edema refers to the localized collection of fluid in an area of the body. The pain usually starts from the upper part of the thigh and gradually spreads all over the legs. If blood flow is stopped, the tissue of the lower legs may undergo necrosis, clinically known as gangrene.

Risk factors
The risk factors are as follows:

Age above 30 years.
Overweight and obese women.
Women with pre-existing diseases of heart and blood vessels.

Treatment
Treatment is undertaken by a specialist doctor. Initially the treatment is started with medications. Very few cases that do not respond to medical treatment may need surgery.

Medications
Most common drug used in treatment of white legs is heparin. Heparin is called an anticoagulant, the drug that prevents formation of blood clot within blood vessels. During administration of heparin, measurement of activated partial thromboplastin time (aPTT) is necessary to assess the effect of heparin therapy. Heparin therapy decreases propagation of blood clot and decreases the risk of gangrene formation. In order to relieve edema, the patient is advised to keep the affected legs in elevated position while lying down in bed. Once these signs and symptoms are relieved, the pain also subsides.

Surgery
If the condition of the patient worsens in spite of medications, surgical measures are undertaken. The affected part of the vein is excised out to relieve signs and symptoms. During surgery, a few other steps are undertaken to decrease the risk of recurrence of thrombosis. Heparin therapy is also continued simultaneously during surgery.

Prevention

1. A few preventive steps may help pregnant women to prevent development of white legs during pregnancy:
2. The patient must report to the doctor if she can detect any warning symptom of white legs.
3. The doctor may prescribe some medications to prevent development of white legs during pregnancy.
4. Pregnant women may be advised by the doctor to wear compression stockings. This is helpful in preventing edema and stasis of blood within blood vessels.
5. During pregnancy, women should not confine themselves to bed. They should be active as far as possible and walk every day to maintain proper blood circulation in the legs.