During pregnancy, which changes are expected?

• A. No edema, no venous changes.
• B. Bilateral pitting edema at the end of the day and third trimester is expected; Vasodilation may occur; Venous pressure increases.
• C. Edema only in first trimester.
• D. Venous pressure decreases.

Answer: (B)

During pregnancy the body undergoes notable cardiovascular changes: blood volume expands significantly and hormones like progesterone cause systemic vasodilation, lowering resistance. At the same time, the growing uterus puts pressure on pelvic veins and the inferior vena cava, which can slow venous return from the legs. The combination of more fluid in the circulation and mechanical compression leads to edema, especially in the lower extremities, and it tends to be bilateral and pitting. This is most common toward the end of the day and in the third trimester when the uterus is largest. Venous pressure in the legs increases rather than decreases, and vasodilation is part of the normal adaptation. Edema in the first trimester is not typical, and the expectation is not that venous pressure would drop.