LYMPHEDEMA AND PREGNANCY
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--------------------------------Pregnancy and Lymphedema
Several months ago one of our readers asked whether
pregnancy caused lymphedema
to get worse. I reviewed the published literature and, as is too often
the case,
found very little published information. In addition, what information
was
available was based on very limited numbers of patients. To gain
additional
understanding about pregnancy and lymphedema, I created a pregnancy
survey for
our readers. 13 women have responded to that survey and I am including
a summary
of their responses and insights.
12 of the 13 women had primary lymphedema. The average age of onset was
10 years
of age and the range was from 1 to 16 years of age. 1 patient had
breast cancer
and a mastectomy and developed lymphedema during her first pregnancy 9
years
later.
Of the 12 patients with primary lymphedema, 9 of 12 (75%) had the onset
of
lymphedema or developed worse lymphedema during their pregnancy. Most
of these
women found that the lymphedema got worse in the final months of their
pregnancy. 2 women reported having persistent lymphedema after delivery.
8 women reported second pregnancies and 5 of the 8 (63%) had worsening
of their
lymphedema and all reported that the lymphedema was worse with the
second
pregnancy. All 3 women who did not report worsening of their lymphedema
had
miscarriages that occurred between 3 and 5 months of gestation.
4 women reported having third pregnancies and 3 of the 4 had worsening
lymphedema with the pregnancy and all reported that the lymphedema
became
progressively worse with each pregnancy. The remaining woman had a
miscarriage.
One woman reported a 4th pregnancy and had worsening lymphedema with
the 4th
pregnancy but that the lymphedema got better after the delivery of her
child.
The one respondent with secondary lymphedema commented that she had
been free of
lymphedema for 9 years after her mastectomy but developed lymphedema in
her hand
and forearm during her first pregnancy.
The only women not reporting worsening of their lymphedema during their
second
and subsequent pregnancies had miscarriages. Miscarriages occur in
about 10% of
pregnancies so it is notable that so many of the women responding to
this survey
reported miscarriages. Please keep in mind that a small number of women
responded to this survey and any results represent the bias of any
small sample.
However, it is also possible that the incidence of miscarriages is
higher than
the expected in women with lymphedema. I will continue to report on
additional
findings of this survey as we get more information.
Many of the comments made by the women provided interesting insight
into the
problem of lymphedema during pregnancy so I have included a sample of
these
comments below.
Comments:
"I am currently in my eighth month of pregnancy and have doubled the
size
of my left leg. Prior to the pregnancy, I had not swelling in my right
leg. Now
in my eighth month of pregnancy, my right leg is swelling. I am hoping
the
swelling in my right leg will go away after the baby is born."
"By 11-12 weeks of pregnancy, my leg was fuller and growing
uncomfortable.
I was able to continue working full time as a nurse until the 20th week
of
pregnancy. At that point my leg was heavy and uncomfortable. I was
comfortable,
however, if I was lying down. During the pregnancy, I gained over 60
lbs., I was
very congested in my entire body. I remember having to put my left leg
and foot
under cold water to reduce the discomfort. I was unable to wear any
shoes other
than ballet slippers, and could only do minimal walking around the
house. After
my daughter was born, one to two weeks after her deliver, my leg
returned to
essentially a pre-pregnancy baseline. My leg improved as I took off the
weight
gain of fat that naturally occurs with pregnancy. "
"I am currently at the last stage of my third pregnancy, and the
swelling
is once again more pronounced than in previous months. I tend to be
lazier about
the stockings this time, so my swelling could probably be better."
"Thank you for posting this survey, I would have enjoyed having some
preview of the effects of childbirth on lymphedema. Overall, pregnancy
was a
temporary setback, which is an important consideration. However, I was
still
uncertain enough not to attempt my good luck with a second pregnancy.
Who knows
what the outcome would be, especially after age 35. My personal
experience with
this condition has led me to believe that insect bites are far worse
for my leg.
If I get bites on my left leg, my leg gets worse, and doesn't want to
return to
baseline. It's as if I "loose ground" whenever this happens. The
increase with pregnancy, although very substantial, was reversible. It
seemed to
me to be in indication of lymphatic system overload, rather than tissue
scaring
or damage. I did notice that as my weight returned to normal, my leg
kept
improving."
Tony Reid MD Ph.D.
http://www.lymphedema.com/preg.htm
Acknowledgment
Peninsula Medical, Dr. Reid's Corner
http://www.lymphedema.com/
..........................................
Pregnancy
and Lymphedema: Followup
Last year I presented data on the relationship
between pregnancy and lymphedema.
Since that time more women have responded to the survey and I presented
the
update of that survey at the Lymphedema conference held in Dallas,
Texas
sponsored by Healthtronix.
This survey was prompted by several questions that were sent to me
asking
whether pregnancy worsens lymphedema. For example, a woman had primary
lymphedema and was considering an abortion because she was very fearful
of her
lymphedema getting worse. She already had a bad case of lymphedema and
felt that
if it got much worse she would no be able to function. There was no
published
data to help answer these questions and so I posted a survey on our web
site to
help find some answers to this question.
First, I want to say that the results of the survey are limited by a
number of
factors. The number of women answering this survey, while growing, is
still
relatively small. In addition, this is not a random sample of all women
with
primary lymphedema who have had a pregnancy and effective treatment may
change
the outcome. This survey only documents the experience of the women who
have
responded. However, I appreciate the fact that these women have taken
the time
and effort to answer these questions and I hope that this project will
continue
to develop and provide additional information that is helpful to women
facing
this problem.
33 women responded to the survey. Of these, 26 had primary lymphedema
and this
survey will focus on those 26 responses. Most women with secondary
lymphedema
have it as a result of treatment for breast cancer. As a result, the
majority of
these women are past their child bearing years. In addition, the
treatment,
especially chemotherapy, generally causes infertility. So, most of the
women who
have lymphedema during their child bearing years have primary
lymphedema. I will
analyze the results of the women with secondary lymphedema separately.
Since
there are only a few responses, the data is still limited.
The average age of onset of lymphedema in this group of women with
primary
lymphedema was 10.7 years but the range of responses was very wide.
Some women
developed lymphedema at birth while others developed lymphedema in
their late
teens or twenties.
Of the 26 women with primary lymphedema who responded to this survey,
12 of 26
(46%) reported worsening of lymphedema with the first pregnancy. Of the
12 who
had worsening of lymphedema during pregnancy, 7 reported that the
lymphedema
returned to baseline after delivery so that 5 of 26 (19%) reported
persistent
lymphedema after pregnancy. However, among the women who improved after
delivery, 2 of these women subsequently had worsening of lymphedema
within a
year. As a result, 7 of 26 (27%) reported lymphedema that was worse
following
their first pregnancy.
Here are several
comments from these women.
"After delivery my leg went back to it's prior size before becoming
pregnant. However, after 7 months my leg again became swollen and
progressively
got worse."
"In my second trimester my ankles began to swell and the doctor assumed
it
was all normal. After the delivery of my child the swelling in my right
leg /
ankle went away but the swelling in my left leg continued."
These results suggest that about half of the women with primary
lymphedema
experienced worsening of lymphedema during their pregnancy. Among the
women who
reported that their lymphedema worsened with pregnancy, about half of
these
women reported improvement after delivery of the baby. As a result
about 27%
(7/26), of the women with primary lymphedema experienced persistent
worsening of
the lymphedema with pregnancy.
Some of these women had additional pregnancies and I will present the
analysis
of the results in the subsequent edition of eNews.
Sincerely,
Tony Reid MD, Ph.D
http://www.lymphedema.com/preg2.htm
Acknowledgment
Peninsula Medical, Dr. Reid's Corner
http://www.lymphedema.com/
..........................................
NLN Questions and Answers
Should I
wear a sleeve or bandage while pregnant?
Q. I had a lumpectomy and node dissection 8-1/2 years ago and developed
LE
within a year of my surgery. I am very diligent in my self-care, i.e.,
self-MLD,
compression sleeve every day, bandaging every night, professional MLD
once a
year. One question that no one has been able to answer for me is how
pregnancy
affects LE. One doctor told me that I shouldn't wear a sleeve OR
bandage during
pregnancy, while MLD therapists tell me I shouldn't alter my routine at
all.
(FYI: I m not pregnant right now.) I d really like to understand what
will
happen: can the LE become worse, and how best to continue treatment
during
pregnancy? Thanks!
A. There is no documented scientific evidence anywhere stating that
compression
garments should not be worn during pregnancy, or that MLD is
contraindicated
during pregnancy. Of course, modifications in the abdominal
breathing/abdominal
clearance would be made during pregnancy. In fact, for lymphedema of
the legs,
it is essential to maintain compression during pregnancy, to avoid
worsening of
the swelling from abdominal pressure on the great veins. There is an
increase in
total blood volume during pregnancy to support the fetus. This should
not have a
direct effect on the lymphedema in your upper extremity. My suggestion
would be
to continue to follow your usual lymphedema management program,
including
wearing your compression garments and bandaging at night if that has
been your
routine. I know that you are not pregnant now, but I hope that this
information
will allay your fears about your lymphedema worsening during pregnancy.
You can
safely continue to do your self-care program, perhaps with some
modifications,
if you do become pregnant.
Acknowledgment
National Lymphedema Network
http://www.lymphnet.org/lymphedemaFAQs/questions/question_07_00.htm
..........................................
Q: What is the percentage of children born with or
who develop lymphedema
when the mother has primary lymphedema?
A: Due to the inattention given lymphedema in the U.S., we do
not have any
concrete data identifying the number of people born with primary
lymphedema.
Here at the NLN, the number of calls we receive from young parents,
concerned
that their child will inherit the condition, is increasing.
We do see, and talk to, a growing number of people who have multiple
generations
in their family affected by primary lymphedema, and some who have none
at all.
However, a number of my patients with primary lymphedema from both
backgrounds
have had very healthy, lymphedema-free babies who, so far, have not
developed
the condition. So, at this point, it's very difficult to say what the
odds are.
Marlys and Charles Witte, M.D.'s at the University of Arizona (Tel:
520-626-6118), are actively working with a number of families, trying
to
identify some genetic link and/or other correlations. Possible genetic
links are
also being studied in the Department of Human Genetics at the
University of
Pittsburgh, PA. For more info about the study, contact Kara Levinson,
MS, at:
412-624-4657. Or visit their website at:
http://www.pitt.edu/~genetics/lymph/lymph.htm.
This research data will greatly enhance our ability to forecast a
child's
susceptibility.
If you do have a child with lymphedema: there is a new organization
called
"PLAN" (Primary Lymphedema Action Network), which focuses on families
with young infants born with primary lymphedema. For more information,
call
Wendy Chaite: 516-625-9862.
Q: Are there concerns of permanent deterioration or
worsening of a
mother's condition if she has primary lymphedema and becomes pregnant
(such as
spreading to the other leg, additional risk of infection,
etc.)?
A: It really depends on the overall condition of the mom. If she is
healthy
without any other medical problems, there should not be a problem. But
it is
very important that couples prepare themselves and realize the
tremendous re-sponsibility.
You'll need to increase your daily care, such as manual lymphatic
drainage twice
a day, wearing well fitted maternity panty hose (45-55 mm/hg) or, as
some women
do, wear an additional stocking to add compression. Avoid sodium and
drink lots
of fluids (water, tea, natural juices, etc). In regard to spreading to
another
limb - and if you are concerned, I would suggest doing a
Lymphoscintigraphy
(contact the Witte's; see answer to question above) - a very
sophisticated
diagnostic tool used to visualize the lymphatics - prior to your
pregnancy.
Also, if you have a history of recurrent onset of lymphangitis in your
leg, you
will be at greater risk of recurrent infection during pregnancy as a
result of
increased weight/swelling and protein in the tissue. If severe enough,
an
infection could cause a miscarriage, so you will want to watch closely
for signs
and symptoms.
The best advice: use common sense and practice meticulous self-care. If
you are
well, there is no reason that you cannot have a healthy, happy
baby.
Q: What are the possible complications from a C-section vs.
vaginal delivery
and its relation to lymphedema?
A: Both procedures have their concerns. Any time an invasive procedure
is
performed on a patient with lymphedema, you want to be careful.
Especially the
woman who has swelling in the pelvic area and lower abdomen needs to
make sure
to take antibiotics just before, during and after the C-section.
Vaginal
delivery always has risk factors as well, especially for a woman who is
in labor
for many hours: usually there is more swelling in the pelvic region and
leg(s)
from pushing. But once the baby is born, swelling usually subsides in a
matter
of days.
Q: Is it safe to undergo Manual Lymphatic Drainage during
pregnancy?
A: Not only is it safe, but it's extremely important to continue
therapy. Your
goal is to keep the leg(s) in its optimum condition. Do not forget to
use lotion
to keep the skin soft and supple. See a podiatrist educated in
lymphedema just
to make sure that you do not have any possible risk factors such as
fungi,
Athletes foot, callouses, etc., which could lead into infection. VERY
IMPORTANT:
Be sure to wear well-fitted high compression maternity stockings.
Additional tips for pregnancy: Educate your GYN and other involved
doctors about
lymphedema. Get plenty of rest, avoid stress when you can, follow the
18 STEPS
TO PREVENTION, and if possible, shoot for winter time for your last
trimester,
when it's cool. Happy Pregnancy!
National Lymphedema Network - page link no longer available
..........................................
Can
UA ultrasound findings be affected by lymphedema in early pregnancy?
http://forums.obgyn.net/pregnancy-birth/P-B.0306/0739.html
..........................................
Primary lymphedema and
pregnancy
[Article in French]
Brunner U, Lachat M.
Departement Chirurgie, Hopital Universitaire, Zurich.
From a retrospective analysis of 15 female patients, it appears that
primary
lymphedema, reversible at first, tends to become irreversible during
successive
pregnancies. A remission takes place following the first and second
pregnancy,
and during a third pregnancy, an irreversible stage is reached.
PMID: 2626470 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2626470&dopt=Abstract
..........................................
Suggestions for lymphedema and pregnancy
I was always taught that pregnancy was an indication FOR
Manual Lymphatic
Drainage and that is was great to have it during pregnancy, provided
there were
no other contra-indications present (or complications to be
considered). As you
are having it regularly anyway, it should not be a 'shock to the
system'.
Some practitioners might choose to avoid the first tri-mester (but this
is more
to do with avoiding being associated should anything go amiss in the
most
vulnerable first three months, I think - although, of course, some
people don't
actually know they are pregnant until well into the three months
anyway).
........
Hosiery - no reason not to wear it.
In fact, anything that you can do (safely) - eg., wearing hosiery and
having MLD
during pregnancy that will help to keep oedema down has to be a good
thing. The
body naturally tends to retain fluid during pregnancy - many women
experience
swollen ankles, carpal tunnel syndrome etc as a natural complication of
the
extra fluid carried. It will likely make any lymphoedema a little more
troublesome, so keeping hosiery on and staying with MLD could help to
keep the
balance.
If you are able, walking in water would be excellent as it is good for
lymphoedema anyway and exercising in water while pregnant is fantastic.
The
water needs to be about the height of your boobs - don't overdo it,
stop before
your muscles get fatigued and wear some old, worn out compression
hosiery while
in the pool for an even greater effect.
The action of walking activates the calf muscles and the lymphatic
system of the
legs, the induced deeper breathing encourages lymphatic return and the
water
acts like an all over MLD massage, supporting the skin. You may find
that you
need to leave the pool to wee quite often!
It is important though, to stop before your muscles get tired. This
avoids
bringing too much extra circulation to the legs as that could lead to
more
oedema.
Your regular MLD practitioner would be the person to talk to - would they be happy?
** From ULKymph Discussion Board - Author is Anne - who not only has lymphedema but is a Vodder Therapist as well **
........
Another members experience:
I have had the L/O
symptoms in both my lower legs
since I was 12 years old although I think I was born with it.
Five years ago I had my beautiful daughter Ellie and although it was
uncomfortable during the last few months as I was carrying extra weight
my legs
did not really suffer.
I am lucky in that my L/O is pretty mild compared to some sufferers,
but I just
made sure that at the end of the day (I was commuting to London for
work) and
whenever they started to ache, I would put my feet up and rest.
I also made sure I wore my support stockings (Jobst I find are the best)
all the time even during the summer when it was warm.
I dont know whether I have passed the gene onto her and I hope to God
that I
havent. I just try not to think about it but I would not be without her
for the
world.
I do notice that my legs do swell up more quickly than say they did 10
years ago
but I dont believe that has anything to do with me being a mum and so
long as
you look after yourself and let your husband/partner spoil you rotten
during
those 9 months I am sure you will be fine.
Its worth talking to your doctor/specialist though to get a qualified
opinion.
..........................................
Lymphoedema and Pregnancy
By Professor Peter Mortimer, LSN Chief Medical
Advisor and
Dr Sahar Mansour, Consultant Clinical Geneticist, St. George's
Hospital, London
Changes in a
Normal Pregnancy
The cardiovascular system undergoes considerable changes during
pregnancy with
an increase in blood output from the heart by at least 50%. Blood
vessels
generally enlarge creating a relatively 'under filled' circulation and
so to
compensate, the kidneys try and conserve salt and water. This leads to
fluid
retention amounting to some 6-8 litres in the body. The dilution of the
plasma
proteins encourages fluid to leak from the blood vessels into the
tissues. A
fall in the threshold of the hormone that encourages a fluid diuresis
maintains
a fluid retention state. By the end of the pregnancy, 80% of healthy
women will
have some degree of oedema.
Very little is known about what happens to the lymphatic system during
pregnancy. If blood vessels enlarge, i.e. relax, then by implication,
lymphatic
vessels are likely to do the same, in which case they will not be as
efficient
at draining fluid. Normally there is sufficient reserve in lymphatic
transport
so that any increases in tissue fluid will be compensated for by
increases in
lymph drainage. If the lymph drainage is already working close to
capacity
because of a genetic or constitutional weakness in the lymphatic system
(but not
so severe as to have produced lymphoedema before), then the extra
demands of
pregnancy may be all that is needed to manifest swelling for the first
time.
Other factors that potentially increase the risk of oedema during
pregnancy are
weight gain and a reduction in exercise levels.While fluid retention
will
increase weight, so will obesity. Lean women who eat to appetite gain
as much as
1kg in the first 10 weeks and women with a tendency to obesity will
gain much
more. Such weight gain will probably have an adverse effect on lymph
drainage,
particularly in the legs. It is difficult to maintain exercise levels
during
pregnancy because of tiredness and the awkwardness the pregnancy brings
to
walking. Exercise is, of course, crucial for good lymph drainage in the
legs.
Like other blood vessels, the veins in the leg tend to enlarge during
pregnancy.
Varicose veins often develop, which will result in a further filtration
of fluid
from the blood into the tissues of the leg and so make oedema worse.
Pre-eclampsia
Pre-eclampsia (used to be called toxaemia of pregnancy) is specific to
pregnancy
and manifests with hypertension (raised blood pressure), a leak of
protein by
the kidney, and oedema. The cause is not known, but the syndrome of
pre-eclampsia
usually develops from the mid-point in the pregnancy (20 weeks
onwards), and
resolves completely after delivery. Generalised oedema is an
inconsistent
feature. It may develop suddenly and is associated with accelerated
weight gain
(due to fluid retention). Although the ankles and feet will be the
commonest
site for the swelling due to the effects of gravity, oedema can occur
anywhere
in the body including the chest and the abdomen (ascites is free fluid
in the
abdominal cavity). The generalised nature of the oedema would suggest
that the
fault lies with the blood vessels leaking more fluid into the tissues
rather
than any failure of the lymphatic system, but nobody knows. As
mentioned
earlier, any such increase in tissue fluid will inevitably demand more
of the
lymphatic vessels to drain the fluid and any failure to do so will
increase the
oedema further.
Diuretics are best avoided in pregnancy because they result in an even
greater
'under fill' of the blood circulation. Drugs called 'calcium channel
blocking
agents' are recommended for the raised blood pressure, but do tend to
interfere
with the working of lymphatic vessels and may increase ankle oedema.
Lymphoedema in
Pregnancy
A major concern of any young female patient with lymphoedema is "What
will
happen to my lymphoedema if I become pregnant?" The answer is that it
is
likely to get worse because of the fluid retention, but it should be
manageable
and fully recover once the baby is born. The extra bodily fluid
retained during
the pregnancy will include the part of the body affected by the
lymphoedema; so
extra effort will be required to ensure that this extra fluid is
drained by the
local lymphatic system that is already failing. So if a leg is affected
by
lymphoedema, for example, then extra measures to control the swelling
may be
necessary. These measures may include longer periods of rest with the
leg
elevated, manual lymphatic drainage, or an additional compression
garment. Not
every woman with lymphoedema suffers any exacerbation of swelling
during
pregnancy. In many, the lymphoedema remains unaffected, and so what is
described
here is the worst case scenario.
There is no reason to believe pregnancy harms the lymphatic system, and
so a
full recovery would be expected following delivery. Nevertheless, as
with
returning to one's original weight and bodily shape, recovery of the
lymphoedematous limb may take a bit of time and effort. Increasing
levels of
exercise and dieting may be necessary.
Genetics,
Lymphoedema and Pregnancy
Primary lymphoedema is due to an underlying abnormality in the
lymphatics.
Although the swelling may not be present until later in life, the
abnormality is
probably present at birth. It is now recognised that there are some
causes of
primary lymphoedema that are inherited. Therefore a woman (or man) with
primary
lymphoedema may have a child with the same condition.
Family History
The best indicator that there is a genetic cause of lymphoedema is the
presence
of other affected individuals in the family. The commonest way that
primary
lymphoedema is inherited is from parent to child. This mode of
inheritance is
called autosomal dominant inheritance. There are two copies of most
genes. An
autosomal dominant condition is due to an alteration, or 'spelling
mistake', in
one of the copies. The baby can inherit either the affected gene or the
unaffected gene, so the risk to the offspring of inheriting an
autosomal
dominant condition is 1 in 2, or 50%. Some of the genetic causes of
primary
lymphoedema are well recognised and are described in more detail below.
Milroy's Disease
Milroy first described a large family with lymphoedema presenting at
birth in
1892. It was clear from the family history that this condition was
autosomal
dominant, and therefore being transmitted from parent to child.Milroy's
disease
presents predominantly at birth with swelling of the lower limbs,
usually the
feet. The swelling can increase, or improve, or remain stable. Boys
sometimes
have extra fluid in the scrotum, but this rarely causes any problems.
Milroy's
disease is not usually associated with any other abnormalities.Most of
the
carriers of this condition have some swelling of the lower limbs, but
it is
recognised that some carriers of the condition are not affected, but
may have
affected offspring. The lymphoedema in Milroy's disease is due to a
lack of
lymphatic channels in the lower limbs (hypoplasia or aplasia). The gene
for this
condition, Vascular Endothelial Growth Factor Receptor 3 (VEGFR3) was
identified
only recently. This gene is important in the development of the
lymphatics of
the baby.
Lymphoedema-Distichiasis
Syndrome
This condition is another autosomal dominant cause of primary
lymphoedema.
However, the lymphoedema usually presents in late childhood or puberty.
The age
of onset and severity of the swelling varies even within families. The
swelling
is usually associated with the presence of extra eyelashes on the inner
side of
the eyelids.
Although the swelling presents later, it is still due to an underlying
abnormality of the lymphatic channels. Lymph scans in affected
individuals have
shown that there are a normal or excess number of lymphatic channels
with
delayed uptake of lymph in the inguinal lymph nodes, suggesting an
abnormality
in the function of the lymphatic channels. The mechanism is still
unknown. This
condition is sometimes associated with other congenital abnormalities.
About one
third of affected individuals have drooping of the eyelid (ptosis)
which
occasionally requires surgical correction. There is a slightly
increased risk of
heart disease at birth (8%). This is not usually severe, but may
require
surgical repair. A few affected individuals also have a cleft palate
(3%).
The gene for this condition has been identified; it is a very small
gene called
FOXC2. It clearly has a role in the development of the lymphatics and
eye, but
very little is understood about its function.
Risk of Inheriting
Lymphoedema
The risk of inheriting lymphoedema for those types where the gene is
known and
in which a family history exists, is approximately 50%, i.e. 1 in every
2
births. There are, of course, many other causes of primary
lymphoedema.Many of
these may be genetic but not inherited. Often the underlying cause is
not known.
The baby is at an increased risk of inheriting the lymphoedema if any
of the
following are present:
How Can You Tell
If the Baby is Affected
Ultrasound examinations performed during the pregnancy may pick up
oedema in a
foot or around the back of the neck, both signs that the child may be
affected.
In the majority of cases, no abnormalities will be observed, and it may
only be
after birth or sometime later in life that the lymphoedema becomes
obvious. In
the future it may be possible to test the baby for the offending gene
during the
pregnancy, but this is not possible at present.
Prevention of
Lymphoedema
In the years to come, we hope it will be possible to correct the faulty
gene
before the baby is born so that the lymphoedema can be reversed. This
has been
achieved in animals, but not yet in humans. Insertion of the normal
gene instead
of the faulty one is called gene therapy. It may be possible to do this
in
adults already affected by lymphoedema. There is hope!
Lipoedema and
Pregnancy
Pregnancy may trigger or exacerbate lipoedema and worsen the
lymphoedema
component of lipoedema.
Lipoedema is a condition that results in swelling of the hips, thighs
or legs in
females. Fluid does contribute to the swelling, but the main component
is fat,
but in a way different from obesity. In addition to swelling, which
gives rise
to a 'bottom heavy' or 'chunky, shapeless legs' appearance, symptoms of
tissue
tenderness and easy bruising are commonplace. Lipoedema tends to
develop or
deteriorate at times of hormonal change, e.g. puberty, pregnancy and
menopause.
The condition may not be apparent during the pregnancy because of all
the other
changes that take place. Following the pregnancy, however, weight loss
may prove
difficult from the lower half of the body (bottom, thighs and legs).
Dieting
tends to result in fat loss from face, neck and chest, but not the
legs.
Treatment is difficult, but a vigorous exercise regimen and healthy
eating are
recommended. The fluid component of lipoedema appears to be related to
poor
lymph drainage from the areas of fat deposition. As the fluid
increases, so more
noticeable oedema develops, particularly in the feet. This is called
lipoedemalymphoedema syndrome (lipolymphoedema). Pregnancy may
therefore trigger
or exacerbate lipoedema.
Conclusions
In summary, in female patients with lymphoedema, pregnancy may create
additional
concerns with regard to adverse effects on the swelling and the fear of
passing
on the condition to any offspring. In most cases these concerns are
unfounded.
Any increase in swelling can usually be managed satisfactorily with the
help of
a lymphoedema therapist, with a full return to normal once the baby is
born. In
many individuals the lymphoedema will not change. In the event of a
child
inheriting lymphoedema, it does not follow that their condition will be
the same
or worse than that of the parent. The recent upsurge in our knowledge
of the
genes and proteins involved in lymphatic growth
http://www.lymphoedema.org/lsn/lsn140.htm#TOP
================================================
Join us as we work for lymphedema patients everywehere:
Advocates for Lymphedema
Dedicated to be an advocacy group for lymphedema patients. Working towards education, legal reform, changing insurance practices, promoting research, reaching for a cure.
http://health.groups.yahoo.com/group/AdvocatesforLymphedema/
| Subscribe: | AdvocatesforLymphedema-subscribe@yahoogroups.com |
Pat O'Connor
Lymphedema People / Advocates for Lymphedema
=======================================================
Lymphedema People
Support Groups
-----------------------------------------------
Children
with Lymphedema
The time has come for families, parents, caregivers to have a support
group of
their own. Support group for parents, families and caregivers of
chilren with
lymphedema. Sharing information on coping, diagnosis, treatment and
prognosis.
Sponsored by Lymphedema People.
http://health.groups.yahoo.com/group/childrenwithlymphedema/
Subscribe: childrenwithlymphedema-subscribe@yahoogroups.com
......................
Lipedema
Lipodema Lipoedema
No matter how you spell it, this is another very little understood and
totally
frustrating conditions out there. This will be a support group for
those
suffering with lipedema/lipodema. A place for information, sharing
experiences,
exploring treatment options and coping.
Come join, be a part of the family!
http://health.groups.yahoo.com/group/lipedema_lipodema_lipoedema/?yguid=209645515
Subscribe: lipedema_lipodema_lipoedema-subscribe@yahoogroups.com
......................
MEN WITH LYMPHEDEMA
If you are a man with
lymphedema; a man with a loved
one with lymphedema who you are trying to help and understand come join
us and
discover what it is to be the master instead of the sufferer of
lymphedema.
http://health.groups.yahoo.com/group/menwithlymphedema/
Subscribe: menwithlymphedema-subscribe@yahoogroups.com
......................
All
About Lymphangiectasia
Support group for parents, patients, children who suffer from all forms
of
lymphangiectasia. This condition is caused by dilation of the
lymphatics. It can
affect the intestinal tract, lungs and other critical body areas.
http://health.groups.yahoo.com/group/allaboutlymphangiectasia/
Subscribe: allaboutlymphangiectasia-subscribe@yahoogroups.com
......................
Lymphatic
Disorders Support Group @ Yahoo Groups
While we have a number of support groups for lymphedema... there is
nothing out
there for other lymphatic disorders. Because we have one of the most
comprehensive information sites on all lymphatic disorders, I thought
perhaps,
it is time that one be offered.
DISCRIPTION
Information and support for rare and unusual disorders affecting the
lymph
system. Includes lymphangiomas, lymphatic malformations,
telangiectasia,
hennekam's syndrome, distichiasis, Figueroa
syndrome, ptosis syndrome, plus many more. Extensive database of
information
available through sister site Lymphedema People.
http://health.groups.yahoo.com/group/lymphaticdisorders/
Subscribe: lymphaticdisorders-subscribe@yahoogroups.com
......................
All
About Lymphedema
For our Google fans, we have just created this online support group in
Google
Groups:
Homepage: http://groups-beta.google.com/group/All-About-Lymphedema
Group email: All-About-Lymphedema@googlegroups.com
......................
Lymphedema
Friends
http://groups.aol.com/lymphedemafriend
If you an AOL fan and looking for a
support group in AOL
Groups, come and join us there.
===========================
For information about Lymphedema
http://www.lymphedemapeople.com/thesite/all_about_lymphedema.htm
For Information about Lymphedema Complications
http://www.lymphedemapeople.com/thesite/lymphedema_complications.htm
For Lymphedema Personal Stories
http://www.lymphedemapeople.com/forum/forum.asp?FORUM_ID=7
For information about Lymphedema Wounds
http://www.lymphedemapeople.com/thesite/lymphedema_wound_care_revised.htm
For information about Lymphedema Treatment Options
http://www.lymphedemapeople.com/thesite/lymphedema_treatment_options_revised.htm
For information about Children's Lymphedema
http://www.lymphedemapeople.com/thesite/lymphedema_childrens_pediatric.htm
=======================================================
Lymphedema Glossaries
http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_people_glossaries
===================================================
At our home page we have 18 categories with 218 articles
on lymphedema, edema, and related conditions:
The Forums
Lymphedema Information
Lymphedema and Edema Related Conditions
Hereditary Conditions of the Lymphatics
Related Medical Conditions
Complications of Lymphedema
Lymphedema Treatment Options
Complete Listings of Therapists and Links
Cellulitis and Related Infections
Wound Information, Care, Treatment
Skin Care, Conditions and Complications
Exercise, Diets, Nutrition
Miscellaneous Interesting Articles section
Resources, Organizations, Support Groups
Government Resources
Advocacy and Lobbying Resources
Resources for the Medical Community
===================================================
Our Home Page: Lymphedema People
http://www.lymphedemapeople.com/
Reviewed Jan. 8, 2011
Please refer to our "Wiki" page:
Lymphedema and Pregnancy
http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_and_pregnancy