TOXEMIA OF PREGNANCY

General Information

DEFINITION--A serious disturbance in blood pressure, kidney function and the central nervous system that may occur from the 20th week of pregnancy until 7 days after delivery.

BODY PARTS INVOLVED--Female reproductive system; kidneys; brain and central nervous system; blood and blood vessels.

SEX OR AGE MOST AFFECTED--Pregnant females.

SIGNS & SYMPTOMS

Mild pre-eclampsia:

• Significant blood-pressure rise, even if still in the normal range.
• Puffiness in the face, hands and feet that is worse in the morning.
• Excessive weight gain (more than a pound a week during the last trimester).
• Protein in the urine.

Severe pre-eclampsia:

• Continued blood-pressure rise.
• Continued swelling and puffiness.
• Blurred vision.
• Headache.
• Irritability.
• Abdominal pain.

Eclampsia:

• Worsening of above symptoms.
• Muscle twitching.
• Seizures.
• Coma.

CAUSES--Unknown. Believed to be caused by a substance or toxin produced by the placenta.

RISK INCREASES WITH

• Poor nutrition.
• Diabetes mellitus.
• Previous high blood pressure.
• Chronic kidney disease.
• First pregnancy. Toxemia during one pregnancy does not mean it will recur with subsequent pregnancies.
• Smoking.
• Excess alcohol consumption.
• Use of mind-altering drugs.
• Family history of eclampsia or pre-eclampsia.

HOW TO PREVENT

• Obtain good prenatal care throughout pregnancy.
• Don't smoke, use mind-altering drugs or drink alcohol during pregnancy.
• Eat a normal, well-balanced diet during pregnancy. Take prenatal vitamin and mineral supplements if your doctor prescribes them.
• Don't use medications of any kind, including non-prescription drugs, without consulting your doctor.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood studies, 24 hour urine study and others to rule out complications.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Treatment will depend on severity. Home care for mild symptoms, hospital care if condition deteriorates, and early delivery if situation is severe. Eclampsia, because of seizure activity, is more likely to require hospital care and rapid delivery (often cesarean section).

POSSIBLE COMPLICATIONS

• Stroke.
• Increased risk of high blood pressure unrelated to pregnancy after age 30.
• Seizures.
• Pulmonary edema.

PROBABLE OUTCOME--If diagnosed and treated throughout pregnancy, toxemia usually disappears without complications within 7 days after delivery. It is fatal in rare cases. If toxemia causes premature labor, the newborn's survival chances depend on its maturity. Fetal death is common.

How To Treat

GENERAL MEASURES--

• Weigh yourself daily and keep a record.
• Ask your doctor about testing for urine protein at home.

MEDICATION--Your doctor may prescribe:

• Antihypertensive drugs to lower blood pressure.
• Anticonvulsants to prevent seizures.

ACTIVITY--Rest often--this is important in controlling toxemia. Rest on your left side to help circulation.

DIET--A special diet is usually necessary. Ask your doctor.

Call Your Doctor If

• You have symptoms of mild toxemia at any stage of pregnancy.
• The following occurs during treatment: Severe headache or vision disturbance. Weight gain of 3 or more pounds in 24 hours. Nausea, vomiting and diarrhea. Cramping abdominal pains. Excessive irritability.