Lymph Drainage in Pregnant Women

Aim. The aim of this study was to evaluate the efficacy of lymph drainage to reduce edema of pregnant women. Method. Pregnant women (30 limbs) from the Obstetrics Outpatient Clinic of the Medical School of Santa Casa in S？o Paulo in the period December 2009 to May 2010 were enrolled in this quantitative, prospective study. The patients, in the 5th to 8th months of gestation, were submitted to one hour of manual lymph drainage of the legs. The volume of the legs was measured by water displacement volumetry before and after one hour of drainage using the Godoy & Godoy manual lymph drainage technique. The paired -test was used for statistical analysis with an alpha error of 5% being considered significant. Results. Manual lymph drainage significantly reduced swelling of the legs of pregnant women during the day ( ). Conclusion. Manual lymph drainage helps to reduce limb size during the day of pregnant women. 1. Introduction During pregnancy, many changes occur in the female organism with the adaptation for the fetus causing numerable complaints, for example, edema of the lower limbs. Peripheral edema is the most common and resilient manifestation in pregnant women. Its etiology includes the retention of sodium and water and changes in the circulation related to the effect of the gravid uterus on the inferior vena cava [1]. Moreover, during pregnancy, many hormonal changes take place including increased levels of progesterone, estrogen, HCG, and prolactin [2]. These higher levels of hormones induce changes in vascular permeability, promoting extravasation of plasma with consequent edema. Other transformations that may occur due to these hormonal changes are the formation of varicose veins, sensation of heaviness, paresthesia, and cramp. The prevalence in the general population of varicose veins is 56% for men and 60% for women with risk factors including age and number of pregnancies [3]. Treatment of varicose veins is usually divided into three types: surgery to remove the veins, medications, and nondrug therapy such as compression stockings. Medications or stockings are used to reduce the symptoms of swelling. One randomized study compared types of intervention used to relieve symptoms or treat lower extremity edema and varicose veins of 159 pregnant women. Sixty-nine women used hydroxyethylrutoside, 35 used elastic stockings and 55 were submitted to reflexology. Hydroxyethylrutoside seems to improve the symptoms of varicose veins, but it is not recommended as there are few studies evaluating its use during pregnancy. Reflexology has provided significant