title: Antepartum or immediate postpartum renal biopsies in preeclampsia/eclampsia of pregnancy: new morphologic and clinical findings.
abstract: BACKGROUND
  Preeclampsia (PE) and eclampsia remain leading causes of maternal and fetal mortality worldwide. The kidney is considered the first and most severely affected organ in women with PE/eclampsia. In this study, we analyzed new morphologic features of kidney biopsies and clinical findings in patients with PE or eclampsia at our hospital.
  
  
  METHODS
  Eight patients with PE/eclampsia underwent renal biopsies during the antepartum (3/8) or postpartum (5/8) period. Maternal clinical findings, major serological indices, neonatal outcomes, and renal histopathologic and immunofluorescent characteristics were reviewed for each case.
  
  
  RESULTS
  Most patients had abnormal serum cholesterol (8/8), triglyceride (6/8), albumin (7/8), and uric acid (5/8). The ratio of blood urea nitrogen (BUN) to serum creatinine (SCr) was elevated in all patients. Five of eight newborns survived. Various degrees of morphologic change were present in the renal glomeruli, and were associated with proteinuria. All patients had deposition of complement factor 4 (C4) in the renal glomeruli and seven had deposition of immunoglobulin M (IgM).
  
  
  CONCLUSIONS
  Endotheliosis, vacuolation of podocytes, proliferation of mesangial cells, and protein casts in the tubule lumens were found in the kidneys of women with PE/eclampsia. Immune depositions of C4 and IgM are major contributors to renal lesions in preeclamptic patients, whose neonates can generally survive. Eclampsia can occur without increased blood pressure.
authors.affiliation: Department of Obstetrics and Gynecology, Research Institute of Surgery, Daping Hospital, Third Military Medical University Chongqing 400042, P. R. China.
authors.forename: Lei
authors.initials: L
authors.lastname: Han
authors.affiliation: Department of Obstetrics and Gynecology, Research Institute of Surgery, Daping Hospital, Third Military Medical University Chongqing 400042, P. R. China.
authors.forename: Zhiling
authors.initials: Z
authors.lastname: Yang
authors.affiliation: Department of Nephrology, Research Institute of Surgery, Daping Hospital, Third Military Medical University Chongqing 400042, P. R. China.
authors.forename: Kailong
authors.initials: K
authors.lastname: Li
authors.affiliation: Department of General Surgery, Research Institute of Surgery, Daping Hospital, Third Military Medical University Chongqing 400042, P. R. China.
authors.forename: Jiaqun
authors.initials: J
authors.lastname: Zou
authors.affiliation: Department of Obstetrics and Gynecology, Research Institute of Surgery, Daping Hospital, Third Military Medical University Chongqing 400042, P. R. China.
authors.forename: Hongmei
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Obstetrics and Gynecology, Research Institute of Surgery, Daping Hospital, Third Military Medical University Chongqing 400042, P. R. China.
authors.forename: Jian
authors.initials: J
authors.lastname: Han
authors.affiliation: Department of Obstetrics and Gynecology, Research Institute of Surgery, Daping Hospital, Third Military Medical University Chongqing 400042, P. R. China.
authors.forename: Lijuan
authors.initials: L
authors.lastname: Zhou
authors.affiliation: Department of Obstetrics and Gynecology, Research Institute of Surgery, Daping Hospital, Third Military Medical University Chongqing 400042, P. R. China.
authors.forename: Xiaojie
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Obstetrics and Gynecology, Research Institute of Surgery, Daping Hospital, Third Military Medical University Chongqing 400042, P. R. China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Obstetrics and Gynecology, Research Institute of Surgery, Daping Hospital, Third Military Medical University Chongqing 400042, P. R. China.
authors.forename: Yingru
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: Department of Obstetrics and Gynecology, Research Institute of Surgery, Daping Hospital, Third Military Medical University Chongqing 400042, P. R. China.
authors.forename: Lili
authors.initials: L
authors.lastname: Yu
authors.affiliation: Department of Obstetrics and Gynecology, Research Institute of Surgery, Daping Hospital, Third Military Medical University Chongqing 400042, P. R. China.
authors.forename: Li
authors.initials: L
authors.lastname: Li
mesh_terms: D000328:Adult; D001706:Biopsy; D004461:Eclampsia / Q000473:pathology*; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D007668:Kidney / Q000473:pathology*; D049590:Postpartum Period; D011225:Pre-Eclampsia / Q000473:pathology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D055815:Young Adult
keywords: Renal biopsy; clinical finding; eclampsia; morphologic finding; preeclampsia