GESTATIONAL INTOXICATIONS (GESTOSIS, GESTATIONAL TOXEMIAS, GESTATIONAL TOXICOSES). — This term is used to group together all those morbid states whose principal characteristics are that they are strictly linked to the state of pregnancy (almost as cause and effect) and that their intimate pathogenic mechanism remains obscure.
The term "gestational intoxications" itself is inappropriate, as it suggests a precise cause, namely identified toxins, which is not the case. This is because such hypothetical toxic substances have never been identified, and, above all, because this theory of morbid causality has now been abandoned by the majority of scholars. It is now recognized, in fact, that pregnancy acts as a complex cause of a biological-hormonal nature which affects and sometimes compromises the entire organism of the pregnant woman; such morbid states often prove to be pathological and severe exaggerations of those manifestations that are proper to pregnancy (such as slight fatty degeneration of the liver, mild albuminuria, solitary vomiting in the first three months, etc.), which are considered physiological both because of their frequency and because they do not harm the pregnant woman in any way.
The main gestational intoxications are briefly outlined below: 1) *hyperemesis gravidarum* or intractable vomiting of pregnancy, which prevents the woman from taking any solid or liquid food, even in minimal quantities, thereby causing first a progressive loss of body weight (up to 500-1,000 grams per day) and then, in very severe cases, death through the stage of cardiac adynamia. 2) *Gestational nephropathies*, in which there are significant degenerative lesions of the kidney, with clinical consequences ranging from mild albuminuria without hypertension, to that with hypertension, edema, oliguria, and even renal failure. 3) *Eclampsia*, a symptomatic complex that almost always follows a severe nephropathy, characterized by tonic-clonic convulsive crises, followed by coma. Gestational nephropathies and eclampsia almost always occur in the last months of pregnancy (7-8%), so that therapeutic interruption of the pregnancy does not prejudice the life of the fetus, which has by then reached a stage of development allowing independent life. 4) *Jaundice and acute yellow atrophy of the liver*, severe degenerative alterations that, often associated with other forms of toxemia, lead to the death of the woman through the picture of severe hepatic insufficiency.
Other morbid states of lesser importance and severity may also be included among the gestational intoxications. The gravid toxicoses that all find immediate benefit in the interruption of pregnancy (induced abortion and premature delivery), which confirms their causal relationship with pregnancy; however, new advances in medical therapy now allow, in the vast majority of cases, the treatment of morbid manifestations and the continuation of the pregnancy to term without endangering the life of the mother or the fetus.