THE RENAL LESIONS OF TOXAEMIA AND ABRUPTIO PLACENTAE STUDIED BY LIGHT AND ELECTRON MICROSCOPY

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Abstract
Summary: Renal biopsy in the early puerperium was carried out on 20 patients with toxaemia and 13 abruptio placentae without preceding toxaemia. The tissue obtained was studied by light and electron microscopy. All patients had a very similar glomerular lesion with (1) swelling and slight proliferation of the endotheliat cells, (2) increase in the number of mesangial cells and the amount of the mesangial matrix, and (3) granular deposits derived from fibrinogen within the endothelial cells and the mesangial matrix.It is suggested that in both toxaemia and abruptio placentae there is release of thromboplastin from the placental site into the circulation which causes disseminated intravascular coagulation; this process is complicated by the fact than in pregnancy the fibrinolytic mechanism is in any case impaired. The glomerular lesion in both groups is the result of the response of the endothelial cells and mesangium to deposited fibrin or its derivatives.