This article concerns the renal lesions seen in the hypertensive disorders of pregnancy. Most of the recent literature on this subject is based on analysis of tissue obtained by needle biopsy of the kidney, a method that has obvious advantages over examination of autopsy material: It avoids the complications posed by the death of the patient and in theory permits repeat collection of samples to allow observation of the course of development of the toxemic lesions. In practice, however, renal biopsies are only rarely performed serially and practically never on control obstetric patients with no proteinuria or hypertension, or on those with symptoms suggesting imminent eclampsia. Rather, in most cases, they are obtained in puerperal patients whose lesions are probably healing. Furthermore, because specimens are small, and lesions may involve but a few glomeruli; they may be missed. Last, in some instances, the technique may lead to crush or traction artefacts.

The following account focuses on the renal lesions seen in fresh autopsy material from women with hypertensive disorders of pregnancy, which are compared with those from control groups of gravidas dying from other causes. This survey, based on a previously published text [1], presents the results only from cases in which the autopsies were performed less than 2 hours after death. Its findings are discussed in relation to recent observations by other investigators.