Toxemia in pregnancy referred to as pregnancy induced hypertension, which may occur in some women during later stages of pregnancy. Toxemia is a severe condition that starts developing, alongside the placental development and mostly occurs in first time pregnant women.
The symptoms include high blood pressure, hyper-reflexia (rapid reflex actions), bloating of face, feet or hands due to fluid accumulation and protein secretion in the urine. These symptoms need to be treated to avoid worsening of the situation, which may lead to convulsions or coma or birth of still born.
Toxemia is a misnomer as it is not caused by toxic substances in the blood as suspected earlier, and is better known as preeclampsia and eclampsia when symptoms get worse. It may also lead to a serious complication, known as HELLP syndrome. Though, the cause is still not defined, it may be due to dietary issues or the result of less blood flow to the uterus.
Moreover, there is no possibility of detecting it before getting pregnant, as it develops during pregnancy itself. Still, blood pressure monitoring and keeping it within safe levels can be beneficial.
Symptoms of Toxemia
These are divided into three stages and each one is progressively more serious than the previous one.
The major signs include puffiness of skin due to fluid retention in various body tissues, mostly around the ankles (edema), mild increase in blood pressure and trace amounts of protein in the urine. Around 7% of pregnant women show mild toxemia.
Severe Toxemia or Preeclampsia
Preeclampsia symptoms comprise of very high blood pressure, extreme levels of edema, dizziness, headache, nausea, vomiting, double vision, severe pain in the upper abdomen and large amounts of protein secretions in the urine. There is also a possibility of sudden weight gain within a day or two.
The most severe stage of eclampsia can be analyzed with signs of convulsions and coma. If this stage progresses, it may cause HELLP syndrome. Around 2 to 12 % of pregnant women suffer from HELLP syndrome, which is fatal causing death in around 2% of cases.
A variant form of toxemia may occur in pregnancy referred as HELLP syndrome. Under HELLP syndrome, the body shows varied changes like hemolysis (H) (red blood cells destruction), elevated levels of liver enzymes (EL), and low count of platelets (LP). The symptoms include epigastric tenderness with quadrant pain from liver distention, severe headaches, visual disturbances, bleeding, swelling, nausea or vomiting, high blood pressure and protein discharge in the urine.
It can be fatal to both the baby and the mother as it may cause stroke or liver rupture in the mother. Since function of liver deteriorates, the only way out is delivery of the baby, even if the pregnancy has not reached its full term. Baby is not safe within the womb and needs to be delivered prematurely.
Treatment of Toxemia
Mild toxemia, preeclampsia or eclampsia cannot be cured, till the pregnancy gets completed. Still, treatment is performed to control high blood pressure and prevent convulsions, through intravenous injections. Magnesium sulfate may be given for those with hyper-reflexia to lower the risk of seizures that can tear off the placenta from the uterine wall.
In specific cases, early delivery could be the only option to ensure survival of the baby or mother or both.