Non-pharmacological Interventions for the Management of Lower Extremity Edema During Pregnancy: A Narrative Review Study

Abstract

Context: The most common cause of bilateral lower extremity edema during pregnancy is venous insufficiency, that is a physiological process. Although it is not a serious complication, it can lead to substantial pain, heaviness, nocturnal cramps, tingling, and numbness. In this regard, foot massage is a prominent non-pharmacological practice among healthcare providers. Objective: This study aimed to evaluate non-pharmacological interventions utilized to alleviate the symptoms of lower extremity edema during pregnancy. Methods: This narrative review included all randomized controlled trials during 2011 - 2021 evaluating the symptoms of lower extremity edema during pregnancy. For literature review, databases including MEDLINE, PubMed, EMBASE, Cochrane, and SID were searched using the following keywords: “management,” “pregnancy,” “obstetric”, “oedema”, “edema”, “pharmacological treatment”, “lower-extremity edema”, “late pregnancy”, and “non-pharmacological treatment”. Results: In terms of analyzed outcomes, there were substantial differences between the assessed trials. The trials had a high risk of performance and detection bias and were essentially unclear for selection bias. Finally, seven studies were included and analyzed. Compression stockings and external massage appeared to reduce lower extremity edema. Conclusions: There is not enough evidence for managing physiological lower extremity edema during pregnancy. Further trials with appropriate methodology and analysis of outcome are needed.