Pregnancy-Induced High Blood Pressure, Toxemia

Some medical researchers describe toxemia as pregnancy-induced high blood pressure. This disease is seen in approximately 3 to 5 percent of pregnancies, usually noted in the third trimester and consists of a triad of hypertension, proteinuria (protein in urine) and edema (swollen extremities). This disease is divided into two categories, eclampsia, which is severe and associated with convulsions and pre-eclampsia which is a milder form of the disease and is not associated with seizures.

It is the elevated blood pressure in toxemia of pregnancy, which is known to cause vascular damage particularly to the arterial circulation. Therefore, pregnant women with toxemia may develop damage to their eyes, due to non-perfusion of the capillaries. Generalized narrowing of arterioles, retinal hemorrhage, intraretinal edema, cotton-wool spots, and papilledema (optic disc swelling) may also be be observed. In addition, one may have and retinal detachments which are often bilateral. Spontaneous retinal reattachment often occurs between one and three weeks postpartum with good visual outcome.

What causes toxemia of pregnancy?

The exact cause of toxemia is not known. There are numerous theories of potential causes which include genetic, dietary, vascular (blood vessels), autoimmune factors. However, none of these theories have been proven. Increased risk is associated with first pregnancies, advancing maternal age, African-American women, multiple pregnancies, and women with a past history of diabetes, hypertension, or kidney disease.

Can this disease be prevented?

No, there are currently no known prevention methods. However, it is most important for all pregnant women to obtain early and ongoing prenatal care. This allows for the early recognition and treatment.

Toxemia is harmful to both mother and baby and the only known cure for toxemia is delivery of the unborn child. However, if delivery would be before the expected birth of the baby, the disease may be managed by bed rest and delivery of the baby will be carried out as soon as the fetus has a good chance of surviving outside the womb. Expected mothers are usually hospitalized, but occasionally they may be managed on an outpatient basis with careful monitoring of blood pressure, urine checks for protein, and weight gain.

What signs may indicate toxemia of pregnancy?

Edema (swelling of the hands and face present upon arising),weight gain in excess of 2 pounds per week. The weight gain may be very sudden, over 1 to 2 days, and headaches. Please keep in mind that some swelling of the feet and ankles is considered normal with pregnancy.

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