Pre-Eclampsia Toxaemia of Pregnancy

Abstract

The toxaemias of pregnancy form a discrete clinical syndrome which has been recognised as a disease of pregnancy almost since the practice of medicine began. Their aetiology and pathogenesis are still unknown, and despite all the resources of modern medicine, there is no treatment more effective than termination of the pregnancy — a therapy which was discovered several centuries B .C. There is no question that the nature of the condition provides one of the most fascinating problems of contemporary medical research, but the urgency of gaining an understanding of the condition, and of evolving more effective therapy, is only seen by considering the damage actually done by the disease, and the toll it still takes of maternal and infant life.

Present day maternal mortality figures are approximately 0.4 deaths per 1000 births. Of these, 18% are due to pregnancy toxaemia, which is second only to abortion as the largest single cause of maternal loss of life. For the child, the risk of stillbirth or early neonatal death is more than doubled in toxaemia, compared with normal pregnancy. It is possible to calculate that the loss of infant life in United Kingdom which can be ascribed to toxaemia is about 3,000 deaths per annum. For comparison, the total number of deaths in road accidents is about 7,000 per annum. Thus pregnancy toxaemia can be taken to be responsible for nearly half as many deaths as our much publicised traffic problem.