Oedema in pregnancy depicts danger and not twin gestation
In Ghana, many occurrences, including but not limited to dangers in pregnancy, for example, oedema in pregnancy, are attributable to strange and superstitious beliefs.
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Regarding oedema in pregnancy, some communities in Ghana believe that it signifies that the pregnant woman carries a twin gestation and not a singleton.
In this piece, we argue extensively on the altar of public education that having oedema or oedematous body parts during pregnancy is a danger sign which calls for swift clinical intervention at the health facility.
It is not a good news to jubilate over. It is not for prayer camps to handle.
Oedema in pregnancy can lead to preventable maternal and newborn deaths if the causative factors are not diagnosed and treated.
We hope this article serves its intended purpose.
Oedema in Pregnancy
Contrary to the widely accepted belief in many Ghanaian communities that oedema or swelling in pregnancy indicates that the pregnancy will lead to the birth of twins, we write to educate the reading public and those who hold this strange belief that oedema in pregnancy can be a danger sign for both the pregnant mother and the unborn baby.
What then is oedema or swelling in pregnancy?
During pregnancy, body fluids may accumulate, causing swelling in the face, hands or feet.
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The extra fluid in the body and the pressure from the growing uterus can cause swelling (or "oedema") in the ankles and feet.
Throughout the day, the extra fluid tends to gather in the lowest parts of the body, especially if the weather is hot or the pregnant woman has been standing for long.
The swelling gets worse as a pregnant woman's expected date of delivery nears.
Specifically, oedema in pregnancy may lead to a sudden increase in swelling in the face, hands or feet; a very bad headache; problems with vision, such as blurring or flashing lights in the eyes; severe pain below the ribs and vomiting with any of these symptoms.
Is Oedema in pregnancy dangerous?
It is normal for a pregnant woman to get some swelling (oedema) in pregnancy, particularly in the legs, feet and fingers.
However, if the swelling is severe and it creates dimple-like pits when touched, then it is a sign of pre-eclampsia (hypertension disorder).
Pre-eclampsia is a dangerous sign in pregnancy and thus a condition that needs to be clinically monitored to save the lives of the pregnant woman and the unborn baby.
An unmonitored pre-eclampsia can lead to maternal and perinatal deaths.
This is because pre-eclampsia can damage organs such as the brain, kidneys, lungs, or liver, and cause problems for the baby, as well as eventually cause the pregnant mother to fit (experience seizure) and die.
When the swelling or oedema occurs gradually, it is not usually harmful, even though uncomfortable.
However, a sudden swelling can be a sign of pre-eclampsia.
The foregoing clinical explanations thus debunk the long-held belief that oedema or swelling in pregnancy is a sign of twin gestation.
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Quite apart from this belief, some Ghanaian communities also hold the view that unprogressive labour is a sign of infidelity on the part of the pregnant woman.
These and many other strange beliefs regarding pregnancy are inimical to maternal healthcare delivery, leading to many preventable maternal and perinatal deaths.
Reducing swelling
Many ways of reducing swelling in pregnancy have been suggested in clinical literature. It is suggested that the pregnant woman can do the following to reduce the oedema: avoid standing for long periods; wear comfortable shoes and socks; rest frequently, with the legs elevated and drink plenty of water, which helps the body get rid of excess water.
Also, exercise – try to take regular walks during the day or do foot exercises.
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Foot exercises improve blood circulation, reduce swelling in the ankles, and prevent cramps in the calf muscles.
Also, attend the Ghana Health Service (GHS) pregnancy schools for comprehensive education regarding pregnancy and its complications.
Pregnancy school
In order to give comprehensive obstetric and maternal health education to pregnant women and their spouses, GHS introduced the pregnancy and daddy school concept.
Participation in the GHS pregnancy schools may help pregnant women discard strange beliefs regarding pregnancy and how to manage certain pregnancy complications such as oedema.
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The pregnancy school lessons are offered in almost all GHS hospitals providing maternal health services.
According to Dr Linda Vanotoo, a former Greater Accra Regional Director of Health Services, the main objective of the pregnancy school concept is to “create a forum for the provision of relevant information on pregnancy and newborn care to pregnant women and their families in a friendly environment, and to involve male or husband participation in maternal and newborn healthcare delivery, including family planning.”
The pregnancy school lessons provide certain additional information that the pregnant woman could not have obtained during consultation at the antenatal clinics.
This is because the pregnancy and daddy schools are more interactive and participatory for both the pregnant women and their husbands.
It helps to clear doubts and blame games in some marriages regarding obstetrics, strange beliefs in pregnancy and the consequences of failure to seek such care on time.
Conclusion
Oedema in pregnancy is not a sign that the woman will give birth to twins.
Rather, body fluid accumulates during pregnancy because the adrenal glands produce more of the hormones that make the body retain fluids (aldosterone and cortisol).
Fluid also accumulates because the enlarging uterus interferes with blood flow from the legs to the heart.
Accordingly, prayer and other spiritual camps that offer spiritual solutions for pregnancy complications such as oedema and pre-eclampsia, and pregnant women who seek solutions therefrom should desist from such acts.
Advisedly, male spouses and pregnant women should rather take advantage of the GHS Pregnancy school lessons and become educated.
For lack of knowledge, my people perish!
The writers are: A Hospital Administrator Email: afetikorto@yahoo.com & A Health Service Administrator Email: boalenawuni@gmail.com