The pathologic anatomy of eclampsia, bilateral renal cortical necrosis, pituitary necrosis, and other acute fatal complications of pregnancy, and its possible relationship to the generalized Shwartzman phenomenon

Abstract

Intravascular fibrin deposition in arterioles and capillaries throughout the body is responsible for the necrosis and hemorrhage seen in eclampsia, bilateral renal cortical necrosis, and pituitary necrosis associated with pregnancy. These cases are often accompanied by severe shock, hemorrhage, and anuria. Fibrinogenopenia and fibrinolysins develop in this group of patients. It is suggested that the mechanism behind the fibrin deposition is similar to that in the generalized Shwartzman reaction. In some cases the source of “toxin” may be a bacterial infection. In some cases, particularly those associated with toxemia of pregnancy, the “toxin” may be similar to the “menstrual toxin” described by the Smiths.