Preeclampsia is the first stage of a pregnancy condition commonly called toxemia.

The earliest signs of toxemia (preeclampsia) must be detected to prevent the condition from progressing to full eclampsia which involves convulsions and coma and can result in death.

Editor’s Note: While the term “Toxemia” was widely used at the time this course was originally written, it has been largely abandoned in favor of the term “Pre-Eclampsia.”

a. Signs and Symptoms. Problems indicating preeclampsia may develop over the period of a few days or appear suddenly in a 24-hour period. Included are the following:

(1) High blood pressure. The patient’s small blood vessels become constricted, leading to many changes, among them:

a. Elevated maternal blood pressure.

b. Loss of plasma into the extravascular spaces.

c. Decreased perfusion of organs.

d. Consumption of platelets, sometimes faster than they can be replaced.

(2) Edema, usually of the face, hands, and/or feet.

(3) Headaches.

(4) Blurred vision.

(5) Abdominal pain.

b. Treatment. If treated early, it is possible to prevent preeclampsia from progressing rapidly to full-blown eclampsia with seizures before, during, and sometimes after delivery.

(1) Record a blood pressure and the presence or absence of edema in every pregnant woman you examine. Do this regardless of what the patient's chief complaint is.

(2) Be suspicious of any blood pressure above 130/80.

(3) Give supportive care and direct the patient to an obstetrician.