Some historical aspects of toxaemia of pregnancy: a review
Article Abstract:
Toxemia is a complication of pregnancy characterized by convulsions, nephritis (inflammation of the kidney), albuminuria (excretion of the blood protein albumin in the urine), hypertension, edema (accumulation of fluid in tissues), blurred vision and headaches. Eclampsia is the end stage of toxemia, and is characterized by coma and seizures. Most studies suggest that toxemia results from the effects of a toxin in the blood on nerve tissue. Because the cause of toxemia is not known, treatment of this disorder may be difficult. Delivery of the infant cures toxemia, but is associated with risks, especially if the birth is preterm. Efforts to prevent toxemia have focused on providing prenatal care that includes regular measurement of blood pressure and analysis of urine. Researchers have reported rates of toxemia from 190 to 576 cases per 100,000 deliveries; 85 to 90 percent of toxemic deaths are due to eclampsia. In the mid-1930s, maternal deaths resulted from sepsis, or bacterial infection of the blood, in 30 to 40 percent of cases; from toxemia in 20 percent; and hemorrhage in 15 percent. Maternal mortality due to toxemia/eclampsia ranged from 50 to 150 deaths per 100,000 births in Western countries. Higher rates of death in specific regions, such as the southern United States, may be related to poor standards of prenatal and maternal care. The trend in mortality due to toxemia shows a steep, continuous decline after the mid-1930s. By 1960, the death rate due to toxemia had reached similar levels in many Western countries. The introduction of the antibiotic sulfonamide reduced mortality due to sepsis, whereas development of the drug ergometrine and wider use of blood transfusion reduced rates of death due to hemorrhage. Mortality due to toxemia decreased from 18 percent between 1931 and 1935 to 25 percent between 1971 and 1975. In developing countries, current trends in mortality due to hypertensive disease in pregnancy resemble the trends observed in Western countries in the 1920s. Difficulties are anticipated in efforts to further reduce mortality due to toxemia and hypertensive disease in pregnancy. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: British Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0306-5456
Year: 1991
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Congenital and maternal cytomegalovirus infections in a London population
Article Abstract:
Cytomegalovirus (CMV), a herpesvirus, is the most common cause of intrauterine infection. Previous studies have shown that infected mothers can transmit CMV to their babies. However, there is no screening technique available that allows the identification of pregnant women who are at risk for transmitting the CMV infection to their babies. In an attempt to develop such a method, 3,315 pregnant women and 2,737 of their babies were examined. Blood samples from the mothers and urine samples from the infants were tested for CMV. Sixty percent of the mothers had antibodies against CMV in their blood, indicating that they were either currently infected or had previously been infected with CMV. However, only 9 of the 2,737 babies tested positive for CMV infection, and only two of the nine infected babies had symptoms associated with CMV infection. Both of the babies with symptoms were born to mothers who had a recurrent infection during pregnancy. The other seven babies with CMV were born to mothers who previously had CMV infection, but did not develop an infection during pregnancy. It is concluded that testing maternal blood samples for the presence of CMV antibodies is not a useful method for identify mothers at risk for having babies infected with CMV. It is suggested that in the future, when a prototype CMV vaccine becomes available, CMV vaccines should be used to immunize children against CMV infection. Vaccination of pregnant women will prevent the mother from developing a first-time CMV infection during pregnancy, but will not prevent the transfer of CMV to babies from mothers who have had CMV infection in the past. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: British Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0306-5456
Year: 1991
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