ONE MONTH before her expected date of confinement, a 25-year-old mother of six came to the emergency ward of the Cincinnati General Hospital because of the abrupt onset of rapid pulse, dyspnea followed shortly by headache, blurred vision, abdominal pain, nausea, and finally bloody vomiting. Blood pressure was 180/80 mm Hg. Two weeks earlier a like episode had subsided spontaneously. In other respects her pregnancy had been normal, and routine blood pressures in the prenatal clinic had ranged from 98/60 mm Hg to 130/50 mm Hg. Later, she recalled having had a similar experience at the end of a previous pregnancy 18 months before.
She was admitted to the obstetrical service of the Cincinnati General Hospital with the diagnosis of possible myocarditis. Her symptoms subsided promptly on sedation and bed rest. Blood pressure (118/80 mm Hg), pulse (80 beats per minute), and eye grounds were normal, and aside from a