Health Care Practitioners’ Self-Reported Knowledge, Skill Level, and Confidence in Evaluating and Treating Lymphedema and Lymphatic Dysfunctions with Individuals who are Pregnant or Post-Partum

Suwanee, GA

The management of lymphedema during pregnancy presents a complex clinical challenge driven by significant physiological shifts, including a 40–50% increase in plasma volume and mechanical obstruction by the gravid uterus. However, current practice relies precariously on oncology-centric models that fail to address these unique hemodynamic demands due to a critical lack of evidence-based guidance. The aim of this study was to investigate the self-reported knowledge, skill levels, and confidence of international health care practitioners regarding the evaluation and treatment of lymphedema in the pregnant and post-partum population.

A mixed-methods international survey was distributed to lymphedema practitioners worldwide in 10 languages to assess practitioner demographics, initial and supplemental training, clinical confidence, and observed patient outcomes. The views of 282 health professionals from 17 countries were collated, with the majority highly experienced: 75.3% had over 5 years of clinical practice. Despite this experience, 68.2% of respondents reported a lack of confidence in treating pregnant patients, revealing a significant educational void where 56.6% received no pregnancy-specific instruction during initial certification. Consequently, 91.3% identified medical concerns and precautions as a critical educational need. A statistically significant correlation was found between supplemental training and clinical confidence, with trained practitioners reporting a 75.9% confidence level compared to 18.0% in the untrained group. Clinical observations highlighted poor patient outcomes under current care models, with over 50% of cases showing non-resolution or worsening of edema post-partum. This pervasive lack of preparedness among lymphedema practitioners to manage the complex hemodynamic needs of the pregnant population drives a therapeutic hesitancy that frequently results in benign neglect and chronic morbidity. To bridge this gap, certification programs must integrate pregnancy-specific physiology modules, and the field must establish international consensus guidelines stratified by gestational week to ensure safe proactive intervention.