The current approach to preclampsia
DOI:
https://doi.org/10.18597/rcog.3248Abstract
In Ancient Greece the believe was that the human body was made up of four types of humors, and any imbalances among them resulted in illness. Women were thought to be more vulnerable to disease because of an overproduction of fluids and due to the presence of a “wandering womb” that could invade her various organs and even cause seizures during pregnancy (1). Hippocrates, the father of medicine, thought that seizures during pregnancy were the result of blood congestion or depletion in the brain (2).
During the Middle Ages religious believes prevailed; charms, magical concoctions, and prayers for healing were used (1). In an attempt to reduce cerebral congestion and prevent eclampsia, Mauriceau recommended performing between two and three phlebotomies during pregnancy, and overstated in his writings the critical nature of the disease (3).
By the end of the 19th Century and early in the 20th Century, physicians in Germany and the Netherlands managed preeclampsia aggressively, delivering the fetus immediately, either vaginally or abdominally. This aggressive obstetric approach dramatically increased maternal mortality. Consequently, the conservative management of preeclampsia gained popularity (4). The pioneers of this method were Tweedy in Dublin and Stroganoff in Russia (1). The former considered that hastening of labor and delivery increased the occurrence of seizures due to reflex mechanisms. The physician should refrain from conducting any vaginal examinations, abdominal palpation, and cervical dilatation. The patient was sedated with high doses of morphine and if the patient went into labor, the application of forceps was permissible (5).
Author Biographies
Carmen Doris Garzón-Olivares
Profesor asociado del departamento de obstetricia y ginecología, Facultad de Medicina, Universidad Nacional de Colombia. Bogotá, Colombia.
Alejandro A. Bautista-Charry
Director del departamento de obstetricia y ginecología. Facultad de Medicina, Universidad Nacional de Colombia. Bogotá, Colombia.
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