BackgroundThis study aimed to use a portable ultrasound method to quantitatively measure skin thickness and to compare leg edema in obese and non-obese pregnant women.Material/MethodsThirty-six pregnant women (17 primiparas and 19 multiparas) at 27/28 and 37/38 weeks of pregnancy, with and without leg edema, had their lower leg skin thickness measured using a B-scan portable ultrasonography device (72 legs and maximum of 98 measurements). Measurements were compared between women who were obese prior to pregnancy, with a body mass index (BMI) ≥25 kg/m2 and non-obese with a BMI <25 kg/m2.ResultsSkin thickness of the legs in pregnant women with edema was significantly increased compared with that in pregnant women without edema (6.4±0.3 mm vs. 4.6±0.4 mm) (p=0.0001). There was a significant correlation between the degree of pitting edema and skin thickness in all edematous legs (ρ=0.56; n=98; p<0.0001). The cutoff level of edema measured by portable ultrasound in non-obese pregnant women was 4.7 mm (sensitivity 83.9%, specificity 66.7%) and was 7.5 mm in obese pregnant women. Obese pregnant women with edema had a significantly increased leg skin thickness compared with non-obese pregnant women with edema (11.3±1.3 mm vs. 5.7±0.2 mm) (p<0.0001).ConclusionsPortable ultrasonography is a reliable method of quantitatively measuring skin thickness of the lower leg in edema associated with pregnancy. The thickness of the skin in obese pregnant women with edema can be expected to be significantly increased compared with non-obese pregnant women with edema.
Several body systems, including the circulatory system, lymphatic system and kidneys, help maintain the appropriate balance of fluids in the body. A problem with any of these systems can contribute to the retention of fluid. Leg and foot edema, caused by the accumulation of fluids in tissue, is known as peripheral edema. Many women have been suffering from leg and foot edema reportedly. In the present review, we describe several methods of treating leg and foot edema in women, such as leg elevation, water immersion, bandage, stocking, foot massage, intermittent pneumatic compression, taking rutoside, reflexology and monitoring the interstitial fluid movement.
The technique most widely used to quantitatively measure leg edema is only a pitting edema method. It has recently become possible to digitize B-mode ultrasound images and accurately quantify their brightness using an image-analysis software program. The purpose of this study was to find new indices of the grade of leg skin, to study whether or not analyses of the subcutaneous layer of leg skin on ultrasound images using image-editing software program can be used to evaluate it and to digitize it. Images of 282 subcutaneous layers of leg skin in 141 pregnant women were obtained using a B-scan portable ultrasound device. Rectangular photographs (vertical: skin thickness; horizontal: width of probe) were obtained using an image-editing program, and the luminous intensity (pixel grayscale: 0–255) and thickness of the skin were calculated using a histogram. We investigated the correlation between these parameters and the grade of pitting edema (0–3). There was a significant positive correlation between the grade of pitting edema and the average luminous intensity value, its standard deviation, and the skin thickness (ρ = 0.36, ρ = 0.22, ρ = 0.51, p < 0.0001, respectively). In particular, there was strong positive correlation between the grade of pitting edema and both the total number of pixels in a rectangle × (multiplied by) the average luminous intensity value and the total number of pixels in a rectangle × the standard deviation of the average luminous intensity value (ρ = 0.58 and ρ = 0.59, p < 0.0001, respectively). We could quantitatively evaluate the grade of leg edema by analyzing ultrasound photographs of the subcutaneous layer of the leg skin using an image-editing software program and found new indices to digitize it.
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