Toxemia Symptoms & Signs: Know What To Look For

By Dr. Kenosha Gleaton, OBGYN

What is Toxemia?

Toxemia is another term to describe preeclampsia, a pregnancy complication that is characterized by high blood pressure, swelling, and a high protein concentration in the urine. [1] Toxemia of pregnancy is often seen during the 3rd trimester but symptoms may develop earlier. [1-2] Toxemia can be very dangerous when not managed quickly and should be taken very seriously.

Causes of Toxemia

Unfortunately, we aren’t entirely sure of the exact cause of preeclampsia. At one point in time, the condition was thought to be caused by a toxin (hence the name toxemia), but we now know this isn’t the case. [3] Research is still ongoing to better understand any potential links or causes of pregnancy toxemia. Current research involves a wide variety of factors, including [4]:

• Genetics
• Placental abnormalities
• Nutritional factors
• Environmental factors
• Hormone imbalances
• Cardiovascular and inflammatory changes

We know that certain factors can put someone at a higher risk of developing toxemia. Some of these risk factors include [5-6]:

• Obesity
• Lupus or other autoimmune conditions
• History of high blood pressure, kidney disease, or diabetes
• Multiple pregnancy
• Family history of preeclampsia
• Age 35 or older

If you fall into one of these categories, speak to your healthcare provider about your concerns and any potential warning signs to look out for.Learn about recurring preeclampsia → 

Symptoms of Toxemia

A scary truth about toxemia or preeclampsia is that many people do not experience any symptoms. This complication can go unnoticed for some time, potentially worsening health outcomes. For those that do experience symptoms, they may notice the following [2,6,7]:

• Swelling in the face, hands, and feet
• High blood pressure
• Headaches
• Changes in vision
• Abdominal pain
• Shortness of breath
• Decreased urine production

While it is important to be aware of the risks and symptoms of serious conditions such as toxemia, the goal here isn’t to scare you. Fortunately most healthcare providers will conduct regular screenings throughout your pregnancy in order to check for warning signs, like high blood pressure.

Severe Symptoms

There are also severe toxemia symptoms that may arise if it goes untreated. Further complications and conditions include HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count), stroke, kidney disease, heart attack, and others. [1,2,6] Symptoms of these conditions may include [5,6]:

• Nosebleed
• Chest pain
• Blurry vision
• Numbness or weakness in the face, arm, or leg
• Confusion or difficulty speaking
• Dizziness
• Fainting
• Shoulder or arm pain
• Heartburn
• Nausea 
• Right-sided abdominal pain

If you ever have concerns or questions about any symptoms you experience, you should speak directly to a healthcare provider. In many cases, fast treatment or management can greatly improve health outcomes. 

Blood pressure should be checked during each prenatal visit. [5] If blood pressure is considered high (140/90 mm Hg or higher), especially after week 20 of pregnancy, additional testing is likely to be performed. [5] Utilizing blood tests and more extensive lab tests, a provider may be able to diagnose one of many conditions. [4] 

Diagnosis of Toxemia

So how do providers actually diagnose toxemia? Truthfully, toxemia isn’t often diagnosed, and the preferred medical diagnosis is likely preeclampsia or eclampsia. [2] In order for someone to be diagnosed with preeclampsia, they will need to speak with a healthcare provider. Depending on blood pressure readings, blood and urine tests, and other testing or monitoring, a provider may be able to diagnose one of many conditions. [4] 

Gestational Hypertension

Gestational hypertension is diagnosed if a pregnant person has high blood pressure but no protein in the urine. It’s possible for gestational hypertension to develop into preeclampsia. [4] 

Mild Preeclampsia

Mild preeclampsia is diagnosed when a pregnant person experiences high blood pressure as well as one of the following [4]:

• The protein content in urine is equal to 0.3 or more grams in a 24-hour specimen OR a protein-to-creatinine ratio greater than 0.3. 
• Blood tests showing liver or kidney dysfunction 
• Visual impairments
• Fluid in the lungs/difficulty breathing

Severe Preeclampsia

Severe cases of preeclampsia can be diagnosed when a pregnant person experiences any of the following [4]:

• High blood pressure (160/110 mmHg or higher on two occasions at least 4 hours apart while on bed rest)
• High levels of protein in the urine
• Test results showing organ damage, such as low platelet count or high liver enzymes
• Severe stomach pain that is unexplained and not responsive to medication
• Symptoms such as visual disturbances, difficulty breathing, or fluid buildup.

Eclampsia

Eclampsia is diagnosed when someone with preeclampsia begins experiencing seizures or convulsions. Seizures may occur before labor, during labor, or after delivery. [4] 

Treatment Options

Treating hypertensive conditions during pregnancy can depend on the severity, clinical presentation (symptoms), stage of pregnancy, and more [2]. 

Bed Rest and Delivery

Often the most effective treatment for preeclampsia symptoms and related conditions is the immediate delivery of the baby and placenta. [2,5,6] If delivery isn’t an option, bed rest may be recommended to reduce stress and help control elevated blood pressure. However, bed rest may not always be the best option for people's body condition as it may cause increased risk of blood clots and impair quality of life. Speak to your healthcare provider directly about any pre and postpartum preeclampsia treatment steps you should take at home. 

Medications

There are many medications available to help in the management and prevention of toxemia and other conditions. Some medications, such as nifedipine, hydralazine, and others may be used to lower blood pressure. [2,5,6] Magnesium sulfate may be used to prevent seizures in those with severe preeclampsia. [2,5] Some medications can also help with the development of fetal lung tissue in order to speed up development and potentially deliver the fetus early. 

Aside from medications and early delivery, healthcare providers may recommend blood transfusions in serious cases, as well as other medical interventions. [2] Your healthcare provider can recommend the best treatment options for you based on your specific symptoms and severity. 

Preventing Toxemia

There is no confirmed method for completely preventing toxemia, however, steps can be taken to reduce or manage risk factors. [5] Healthy eating, weight loss, and regular exercise are a few methods for maintaining overall health and may reduce the risk of hypertensive conditions in the future. [5] Some providers may recommend a small daily dose of aspirin during early pregnancy if someone has multiple risk factors. 

Natalist's Role in Supporting Pregnant Women

While some conditions, such as toxemia, are impossible to prevent, maintaining a healthy lifestyle before and during pregnancy is one of the best ways to promote positive outcomes. [8] We at Natalist are committed to providing you with high-quality products that support health and wellness throughout your pregnancy journey. Support your nutrition during pregnancy with prenatal vitamins, boost your hydration game with pregnancy-safe electrolyte drinks, or prepare for the road ahead with postpartum essentials. We’re rooting for you! 

Dr. Kenosha Gleaton is board-certified in gynecology and obstetrics and is the Medical Advisor of Natalist. She received her MD from MUSC and completed her residency at Carolinas Medical Center in Charlotte, NC.

Dr. Gleaton is passionate about women, youth, and mentoring. She is a Scrubs Camp instructor, a program to increase student entry in healthcare, and serves as a Compassion International adoptive parent. She is also a member of the American College of Obstetrics & Gynecology, the American Association of Gynecologic Laparoscopists, and the American Association of Professional Women.  

References:

1. Ruth A. Lawrence, Robert M. Lawrence. Chapter 16 - Medical Complications of Mothers. Breastfeeding (Seventh Edition). W.B. Saunders, 2011, Pages 550-613, ISBN 9781437707885. 
2. Syed, A. Haag, A. McGowan, J. Toxemia. Osmosis from Elsevier. Accessed July 2023. URL. 
3. What causes preeclampsia and eclampsia? NIH. January 2017. URL. 
4. How do healthcare providers diagnose preeclampsia, eclampsia, and HELLP syndrome? NIH. January 2017. URL. 
5. Preeclampsia and High Blood Pressure During Pregnancy. FAQ034. ACOG. April 2023. URL. 
6. Preeclampsia. Cleveland Clinic. October 2021. URL. Accessed July 2023. 
7. Sibai, B. M. (2012). Hypertension. In S. G. Gabbe, J. R. Niebyl, J. L. Simpson, & M. B. Landon (Eds.), Obstetrics: Normal and problem pregnancies (6th ed.). Philadelphia: Saunders.
8. Good Health Before Pregnancy: Prepregnancy Care. FAQ056. ACOG. December 2021. URL.