Young GL, Jewell D.
Interventions for varicosities and leg oedema in pregnancy.
Cochrane Database Syts Rev 2000;(2):CD001066

Barn Croft Surgery, Temple Sowerby, Penrith, Cumbria, CA10 1RZ.
youngjckvg@compuserve.com

BACKGROUND: Leg oedema from venous insufficiency is not dangerous but it can
cause women symptoms such as pain, feelings of heaviness, night cramps and
paraesthesiae. Leg oedema can be a sign of pre-eclampsia when associated with
raised blood pressure or proteinuria. OBJECTIVES: The objective of this review
was to assess the effects of treatment to relieve the symptoms associated with
varicosity in pregnancy and to reduce leg oedema. SEARCH STRATEGY: We searched
the Cochrane Pregnancy and Childbirth Group trials register. SELECTION CRITERIA:
Randomised trials of any form of treatment for varicosity or leg oedema in
pregnancy. DATA COLLECTION AND ANALYSIS: Trial quality was assessed and data were
extracted independently by two reviewers. MAIN RESULTS: Three trials of three
different treatments were included. A total of 115 women were involved. In one
trial, two thirds of women given rutoside capsules in the last three months of
pregnancy noted an improvement in symptoms compared with only one third given
placebo (odds ratio 0.30, 95% confidence interval 0.12 to 0.77). They had a
decrease in ankle circumference at 36 weeks' gestation after eight weeks of
treatment, while women given placebo had a small increase. In one trial, women
with ankle oedema had a small non-significant reduction in lower leg volume when
treated with external pneumatic intermittent compression for 30 minutes. Fifty
minutes immersion in water at 32 degrees Celsius resulted in greater diuresis and
fall in blood pressure than 50 minutes bedrest. REVIEWER'S CONCLUSIONS: Rutosides
appear to relieve symptoms of venous insufficiency in late pregnancy. However it
is not known if the drug is safe in pregnancy. External pneumatic compression
appears to reduce ankle swelling. Immersion in water for 50 minutes results in
diuresis and fall in blood pressure. It is not known for how long these changes
are sustained nor whether they are of any benefit.