Preeclampsia: A Clinicopathologic Study of 23 Cases

Twenty-three patients presenting between 1973 and 1987 with the clinical signs of preeclampsia in pregnancy and no apparent past history of hypertension or renal disease underwent renal biopsy intrapartum or in the immediate postpartum period. Three groups were identified using light and electron microscopy, the first with the classical glomerular “endotheliosis” lesion of preeclampsia (55% of cases), the second with endotheliosis coexistent with underlying renal disease (40% of cases), and the third with renal disease alone (5% of cases). The major type of coexisting renal disease was glomerulonephritis. Immunofluorescence studies were not of great value in helping to distinguish cases with endotheliosis alone from those with underlying renal disease.The finding of 40% of cases with endotheliosis in association with preexisting renal disease suggests that the previously unrecognised renal pathology in these patients increases their susceptibility to developing preeclampsia in pregnancy