By measuring the serum osmotic pressure of 65 pregnant women, all at seven months gestation, Strauss [Am J Med Sci 190, 1935] demonstrated that the pressure was directly related to protein intake. Serum osmotic pressure, serum albumin, and dietary protein were highest among the 35 non-toxemic women in the study, second highest among the 20 women who had non-convulsive toxemia, and lowest among the 10 women who had eclampsia.
At the eighth month of gestation, 15 of the 20 non-convulsive toxemic women were placed on a diet which consisted of 260 grams of protein and were given vitamin injections; the other 5 were placed on an isocaloric diet which provided 20 grams of protein. The osmotic pressure among the women on the high protein diet increased by an average of 7%; that of the latter group declined 9%. The average daily protein intake of the 20 women was less than 50 grams.
After three weeks on the high protein diet, the symptoms of toxemia (including a reduction in the blood pressure of all 15 women) subsided. There was not one case of fetal mortality. In contrast, only two of the five toxemic women who had been placed on a low protein diet showed a reduction in blood pressure.
Ross [R Ross, S Med J, 1935], who discovered that the incidence of eclampsia was extremely high in areas where beriberi, pellagra, and other diseases of nutritional deficiencies were found, stated that "we have been struck with the number of patients in eclampsia who are in a very poor state of nutrition ...."
Hypovolemia (and usually hypoalbuminemia) precedes the onset of metabolic toxemia of late pregnancy. (T. Brewer, Metabolic Toxemia of Late Pregnancy, 1966; M. Bletka, Am J Ob Gyn 106, 1970) Hypovolemia, which is frequently iatrogenic (when low salt, low calorie diets are recommended), is caused by a deficiency of protein calories, sodium, and/or protein-metabolizing vitamins. Bletka, ibid) Also, hepatic dysfunction usually precedes the clinical symptoms of metabolic toxemia of late pregnancy. Hypoalbuminemia and hypovolemia impair the liver's ability to synthesize sufficient albumin and thereby maintain its detoxification enzymatic functions. (T. Brewer, Am J Ob Gyn 84, 1962) The fact that severe preeclampsia and eclampsia frequently result in specific hepatic ischemic or periportal lesions or infarction further indicates that maternal malnutrition leads to hepatic dysfunction. (H. Sheehan & J. Lynch, World Med J 21, 1974)
In the 1930s Dodge and Frost eradicated eclampsia by instituting a high protein diet. Toxemic women who were placed on a daily diet consisting of six to eight eggs, one to two quarts of milk, meat and legumes improved dramatically. The authors discovered that the average serum albumin level among toxemic women was 21% lower than that of those who had been on a high protein diet and who didn't have toxemia.
Tompkins and Wiehl also lowered the incidence of toxemia through dietary supplementation. (ref unavailable) They stated "the so-called 'toxemias of pregnancy' are in reality nutritional deficiency states."
-Tom Brewer MD & Jay Hodin in 21st Obstetrics Now!, NAPSAC 1977
Reprinted from Midwifery Today E-News (Vol 1 Issue 37, Sep 17, 1999)
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