Antepartum percutaneous renal biopsy.
OBJECTIVE
To assess the value and adverse effects of an ultrasound-guided renal biopsy technique in women with normal and pathologic pregnancies.


METHODS
Biopsy samples were taken from 36 women with hypertensive disease (28 with pre-eclampsia) and 18 healthy pregnant women using a thin needle and an ultrasound-guided biopsy device.


RESULTS
Glomerular endotheliosis, a structural change typical of pre-eclampsia, was found in all hypertensive women, but it was more pronounced in the 28 pre-eclamptic women than in the 8 women with nonproteinuric hypertension. A similar change, however, was seen in 11 of the 18 controls. One serious adverse event occurred, retroperitoneal hematoma, in the woman with the most severe pre-eclampsia.


CONCLUSIONS
Glomerular endotheliosis is not to be considered pathognomonic for pre-eclampsia. Few complications followed renal biopsy in this study, but complications arose in the sickest patient. It is probably not advisable to perform antepartum renal biopsies in pregnant women with a rapidly deteriorating renal function and swollen kidneys. In these women, the biopsy does not facilitate diagnosis and is hazardous.
Wide-Swensson
D
D
Department of Obstetrics and Gynecology, University Hospital, University of Lund, 221-85 Lund, Sweden. dag.wide-swenson@med.lu.se
Strevens
H
H
Willner
J
J
D000328:Adult; D044963:Biopsy, Fine-Needle / Q000009:adverse effects / Q000379:methods; D016022:Case-Control Studies; D004730:Endothelium, Vascular / Q000473:pathology*; D005260:Female; D006801:Humans; D007678:Kidney Glomerulus / Q000000981:diagnostic imaging / Q000473:pathology*; D011225:Pre-Eclampsia / Q000473:pathology*; D011247:Pregnancy; D014463:Ultrasonography