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37
Annual Report for 1933 he discusses the somewhat obscure problem
of high blood pressure in pregnancy and he refers to an enquiry into
the matter which has recently been carried out by members of the
Regional Medical Staff of the Ministry of Health. It was found that
of 661 expectant mothers who had manifested a systolic pressure of
140 m.m. or more, a normal confinement without any adverse symptoms
had occurred in 535 cases. Another 124 of these women had, however,
shown some definite signs of toxsemia of pregnancy such as
headaches and albuminuria, etc. Finally, the remaining 2 women of
this series suffered from definite complications (presumably eclampsia)
which were due to toxaemia in all probability.
These observations have interested me greatly as they confirm our
findings at the Ante.natal Clinics in recent years when blood pressure
estimations have been carried out as frequently and carefully as
possible, namely, that a fair proportion of expectant mothers who
show a systolic pressure of 140 m.m. or over, pass through their
pregnancies perfectly well without any symptoms of toxsemia. I
thought it would be useful, however, to enquire into the history of each
of the 26 cases of this nature that I encountered last year, where a full
history is now available, the confinements having already taken place.
In beginning my investigation, I found that the average age of
the 26 women who manifested a systolic pressure of 140 m.m. or over,
was 28. I discovered next, that 11 out of the 26 cases presented no
symptoms whatsoever of toxsemia of pregnancy, no albuminuria or
marked headache or any extreme swelling of the lower limbs, beyond
what could be accounted for by the increasing pressure on the big
veins at the back of the abdomen. It was most interesting indeed to
note, that several of these people remarked to us how well they felt.
All of these mothers were of course carefully dieted; meat being
excluded from the daily menu as far as possible and eggs only allowed
in moderation, if at all.
Turning to the other side of the picture, I find that definite
symptoms of toxsemia of pregnancy were manifested by the remaining
15 women. The presence of albumin in the urine in each case was
detected during the last few weeks of pregnancy only, as a general
rule, and never in large amounts. Marked headache and definite