Toxemia

Alternative names

Preeclampsia; Pregnancy-induced hypertension

Definition

Preeclampsia is the development of swelling, elevated Blood pressure, and protein in the urine during pregnancy.

Causes, incidence, and risk factors

The exact cause of preeclampsia has not been identified. Numerous theories of potential causes exist, including genetic, dietary, vascular (blood vessel), and autoimmune factors. None of the theories have yet been proven.

Preeclampsia occurs in approximately 8% of all pregnancies. Increased risk is associated with first pregnancies, advanced maternal age, African-American women, multiple pregnancies, and women with a past history of Diabetes, hypertension, or kidney disease.

Symptoms

• Edema (swelling of the hands and face present upon arising)
  
• Weight gain
  o In excess of 2 pounds per week
  o Of sudden onset, over 1 to 2 days
  
• headaches
  

Note: Some swelling of the feet and ankles is considered normal with pregnancy.

Additional symptoms that may be associated with this disease:

• Decreased urine output
  
• nausea and vomiting
  
• Facial swelling
  
• High blood pressure
  
• Agitation
  
• Vision changes (flashing lights in the eyes)
  
• Abdominal pain
  

Signs and tests

• Documented weight gain
  
• Nondependent edema
  
• Elevated blood pressure
  
• Proteinuria (protein noted in urine)
  
• Thrombocytopenia (platelet count less than 100,000)
  
• Elevated liver function tests
  

This disease may also alter the results of numerous laboratory tests.

Treatment

The only known cure for preeclampsia is delivery. However, if that delivery would be preterm, the disease may be managed by bed rest and delivery as soon as the fetus has a good chance of surviving outside the womb. Patients are usually hospitalized, but occasionally they may be managed on an outpatient basis with careful monitoring of , urine checks for protein, and weight.