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Extracted from Survival Guide to Midwifery, 2nd Edition (2012) Diane M. Fraser and Margaret A. Cooper, Oxford; Churchill Livingstone: 2012. Courtesy Elsevier

Oedema is defined as the retention of fluid in body tissues. It can occur in one part of the body, for example as the result of an injury, or it can be more general.

In pregnancy, oedema is unlikely to be observed at the initial assessment but may occur as the pregnancy progresses. Physiological oedema is often associated with daily activities or hot weather. Later in pregnancy the midwife should observe the woman for oedema and ask her about symptoms.

In multiple pregnancies, impaired venous return from the lower limbs increases the tendency to varicose veins and oedema.

Sudden appearance of severe, widespread oedema is suggestive of pre-eclampsia or some underlying pathology and further investigations are necessary.

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