Can someone please answer this OB question

[pencilfloor]

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Can increased estrogen levels during pregnancy cause peripheral edema. I know PIH and the uterus pressing against the IVC can cause edema but can estrogen be a cause as well. Also if estrogen is a cause of edema during pregnancy what is the mechanism.

 

[OveractiveBrain]

Can increased estrogen levels during pregnancy cause peripheral edema. I know PIH and the uterus pressing against the IVC can cause edema but can estrogen be a cause as well. Also if estrogen is a cause of edema during pregnancy what is the mechanism.

(1) DVT Hypercoaguability, maybe. Estrogens (hypercoaguable state) + Immobilty (because she's fat with a baby, and there is already venous stasis from impingement of the IVC) + Some sort of endothelial damage (like smoking) COULD set up a Virchow's Triad, leading to DVT.

DVT can cause decreased flow out of the affected leg, causing fluid to back up.

(2) Post Partum Cardiomyopathy. I have no idea what estrogen does or how this comes about, but heart failure can cause peripheral edema, and, even though its called "post partum" it can occur intrapartum.

(3) Now, I'm no OB, but I'm almost 100% sure that estrogen does not have an impact on how leaky a vessel is. It is unlikely estrogen plays a role in contributing to peripheral edema. So if its a pimp question, I would just say no. If you're fishing, try DVT or Post Partum Cardiomyopathy

 

[sineapse]

I'm sure oestrogen does have a role in vessel permeability. What about that whole cyclical bloating and bloating as a s/e of the COCP?

 

[Rollo]

Doesn't estrogen cause water + salt retention? Therefore, hypervolemic state leading to edema?

Not sure how it retains water + salt though.

 

[colbgw02]

Estrogen can cause whatever it wants. If you need proof, either 1) get your SO pregnant or 2) get pregnant.

 

[deleted252979]

I just finished first year but...

Estrogen is a muscle relaxer > vasodilation > which could increase downstream pressure leading to increased filtration.

However, estrogen also causes an increase in liver proteins which would oppose edema.

But I guess the increase in fluids from pregnancy might favor filtration?

Also a third determinant could be the trimester of pregnancy. For example, in third trimester the baby is bigger and needs more oxygen. Transient ischemia is read by the placenta which releases renin, (there is also increased angiotensinogen because the liver is making more proteins) and this leads to an elevated blood pressure. But at this point, I suppose the main concern would be pre-eclampsia if BP gets too high? (>160) ?

Shrug...

 

[Frozen]

http://endo.endojournals.org/content/30/4/598.short

From 1942. Pretty well studied.

Has no one in this thread ever used google scholar before?

 

[sineapse]

http://endo.endojournals.org/content/30/4/598.short

From 1942. Pretty well studied.

Has no one in this thread ever used google scholar before?

Wow that is so awesome. I wish I could link articles like that. Thanks for answering the question btw.