Abstract
The anatomic and physiologic changes occurring with pregnancy result in a variety
of symptoms affecting the lower extremity. The purpose of this investigation is to
provide a comprehensive look at the lower extremity changes experienced during pregnancy
and correlate symptoms with underlying etiology in a literature review. In this retrospective
study, 100 postpartum women were interviewed regarding the lower extremity changes
experienced in pregnancy. The interview included dermatologic, vascular, neurologic,
and musculoskeletal portions. Results demonstrate more than 50% of women reported
faster toenail growth, roughened toenail texture, increased dryness of the skin, swelling
of the foot, ankle, and leg, unsteady gait, increased foot width, and hip pain. Though
a majority of patients did not experience the remaining symptoms represented in the
interview, all results are pertinent and deserve understanding to provide better insight
and care for the pregnant woman. Therefore, a thorough literature review is presented
to correlate the outcomes of the present study with previously published research.
Level of Evidence
Keywords
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Article info
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
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© 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.