Pre-eclampsia & Eclampsia Detection & Treatment 1950's

[DoGoodThenGo]

Ok, am watching last night's installment of "Call the Midwife" see:

http://video.pbs.org/video/2291319164 , and one of the patients is a young mother to be who is new to the area but is more middle class (posh) the what we've seen so far.

As her storyline develops we learn she has "headaches" and other complaints of "not feeling well", but neither her OB/GYN nor anyone else seems that concerned. After a really bad headache and *really* feeling out of sorts she goes to the local free NHS OB/GYN/Mother Baby clinic set up by the midwives and nuns. The intake nurse sort of brushes the woman off with " I need to take down some information..."and so forth while all the time the patient just wants to see a doctor. Told to wait being surrounded by "docklands" mothers and their babies/children get to be too much especially after being told off and almost attacked by one, so she leaves.

About several days later the woman calls her husband at work requesting he come home at once and take her to their normal doctor. During the drive she starts saying things like she cannot remember this or that and soon goes into eclampsia having seizures and lapses into coma. Long story short the infant is lost and the woman is simply kept comfortable in hospital (on a ward but behind a glass walled section) and basically allowed to slowly die.

Now one has seen the midwives in this show constantly testing urine for protein (using a bunsen burner and test tubes) so am wondering why her normal OB didn't notice anything was wrong. Also when did some of the preventive and or treatment options we have for pre and Eclampsia take from in North America and UK? The voice over in the program states at that time nothing could be done for the woman nor her child (born at 27 weeks), and according from what (limited) research one has done so far nurses of the period state pretty much women were put into a darkened room and waited for nature to take it's course.

[GeneralJinjur]

Interesting. When my grandmother had it in the mid-1950s in the rural US, she was given diuretics to lower the bp. Oddly enough, she had it with her 3rd child out of 6 and not with any other pregnancy.

Thanks for mentioning the show. I almost never turn the TV on to a local channel, so I would not have seen it advertised.

[Pepper The Cat, BSN, RN]

My Mother lost her first child to pre-elcamsia - or as they call it in the early '60s, possibly late 50's, "toxemia".

As it was summer, and my Mother was using an Outhouse, she never saw that her urine was changing in colour. It was only during a routine check up that she was asked to provide a urine sample and the urine was , (to quote my Mom) "black" that a problem was discovered. ( I'm still not sure how much of this is accurate- Mom was well into her Alzhemiers when she told my SIL this story)

She never talked about it, but from little tidbits I could gather, her blood pressure was through the roof. The baby girl was still born - I don't know if she was full term or not. Post delivery, my Mother was put on a very strict sodium restricted diet- to the point she had to beg her doctor to say she could have milk with her meals (my Mother LOVED milk!)

I think there might have been some post-delivery delirium as she once mentioned "sleep walking" after the still born delivery.

Unfortunately, both my parents had/have this severe reluctance to discuss medical issues so I never really got the whole story.

She once mentioned how a nurse woke her up in the middle of the night because the nurse could not tell if my Mother was breathing or not - my Mother was a stomach sleeper.

After this, my Mother was able to give birth to 3 babies - all more or less healthy - I have a disease that randomly develops intvitro- but that is an entire different tale.

What does this have to do with OP? I'm not sure. But I think if Mom's pregnancy had occrued in teh 2000's instead of the 1960's I might have an older sister!

[klone, MSN, RN]

It wasn't until the '60s and '70s that MgSO4 was routinely used in the US, along with antihypertensive medications, to treat pre-eclampsia.

It's standard of care now, if a pregnant woman indicates frequent headaches, that they will automatically do a PIH panel on her, and possibly a 24-hour urine.

[BonnieSc]

This isn't related to the eclampsia question, but I thought the nurse-midwife responded appropriately to the patient. The patient was trying to bypass the official channels, acting like she was better than the other patients, and disrespecting the expertise of the nurse-midwife. The "moral" of it--well, one of them--was that if she hadn't felt like the clinic was beneath her and left without being seen, the eclampsia would have been discovered... not that, as the nurse-midwives later say, it would have done any good--apparently.

[xoemmylouox, ASN, RN]

I am glad for the medical advances that have been made. I wonder what the next 20 years will bring for pregnant women and premies.

[karenjoydelay]

This isn't related to the eclampsia question, but I thought the nurse-midwife responded appropriately to the patient. The patient was trying to bypass the official channels, acting like she was better than the other patients, and disrespecting the expertise of the nurse-midwife. The "moral" of it--well, one of them--was that if she hadn't felt like the clinic was beneath her and left without being seen, the eclampsia would have been discovered... not that, as the nurse-midwives later say, it would have done any good--apparently.

[NurseNora, BSN, RN]

In the 60s we were giving IV MgSO4 for pre eclampsia and felt we were really on the cutting edge since many other hospitals were still giving it IM. Five grams in each buttock. A kind doctor would add a little lidocaine in each shot because it really hurt. In a text book from the turn go the century (not the most recent turn, the one before that), I read about the treatment of an eclamptic woman with MgSO4. They used it orally, because at that time the treatment was to get rid of the "toxins" causing toxemia by purging the patient with emetics and laxatives. Oral Epsom Salts is a laxative.

i love that show. It's worth watching on Netflicks if you haven't caught it on PBS.