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February 6, 1954

The Hypertensive Disorders of Pregnancy

JAMA. 1954;154(6):542. doi:10.1001/jama.1954.02940400080035

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This monograph has three main chapters: (1) clinical aspects, (2) physiological and biochemical changes in normal pregnancy and toxemia, and (3) etiology of toxemia. Page has modified the classification of toxemias recommended by the American Committee on Maternal Welfare. He divides them into two main groups: (1) specific toxemia of pregnancy, including (a) preeclampsia (nonconvulsive) and (b) eclampsia (convulsive); (2) clinical entities symptomatically related to toxemia, including (a) generalized edema of pregnancy (not accompanied by hypertension or proteinuria), (b) essential hypertension and pregnancy, with and without superimposed toxemia, (c) primary renal disease (any type) and pregnancy, with and without superimposed toxemia, and (d) post-toxemic recurring hypertension in multiparas. He maintains that eclampsia without hypertension or proteinuria is as much a misnomer as eclampsia without convulsions and that uncomplicated disturbances of salt and water balance during pregnancy should be segregated as a clinical entity distinct from preeclampsia. He emphasizes that severe

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