Renal Histo-Pathological Changes On Autopsy In Pregnancy Related Deaths

Introduction: Medico-legal autopsies confirm the immediate cause of death and final diagnosis. These also provide additional information about the state of various vital organs of the body and existing co-morbidities that could have affected the outcome of the patients. Not much data is available on incidence of Biopsy/ autopsy proven cases of renal pathology in pregnant/ pregnancy related deaths. Aims: The study aimed at finding out prevalence and pattern of various types of renal pathologies and their co-relation with various pregnancy related causes leading to death where autopsies were performed. Material & Methods:The study consisted of eleven cases of autopsies conducted on cases of deaths of pregnant ladies who died having medicolegal problems or alleged medicolegal negligence. The kidney tissue specimens were fixed in 10%formal saline for 48-72 hours before processing. H&E stains and PAS stain were performed on sections from paraffin blocks. Results: The study demonstrated renal changes in a very high percentage of cases, which were mostly related to the ongoing pre-existing disease processes contributing towards cause of death. Conditions like eclampsia were associated with hydropic changes in kidney. Similarly, deaths due to hemorrhagic shock were associated with acute tubular necrosis/ hydropic changes in the kidney. Non-gestational causes of death like disseminated tuberculosis was also associated with renal tuberculosis. Conclusions: The Physician must be aware of the high prevalence and wide spectrum of possible pathologies in the kidney related to various obstetrical complications. The focus should be to develop more efficacious diagnostic methods for timely intervention.