Pathology of Pregnancy Toxemias.

In an attempt to determine the cause and nature of the toxemias of pregnancy, the records of patients who were admitted to the New Haven Hospital with the diagnosis of toxemia of pregnancy or who had renal or vascular disease that had apparently arisen during pregnancy have been reviewed. Altogether 309 of the first class and 11 of the second were found with records complete enough to warrant analysis. Of this group 53 died and 25 came to autopsy. The present paper deals with 23 of these autopsies. One of the 25 was omitted because the data of the autopsy, which was performed at another hospital, are inadequate; the second because there is some doubt about the diagnosis of toxemia. This patient had a diaphragmatic hernia which was responsible for her death and possibly for the earlier symptoms that were ascribed to toxemnia. The essential postmortem findings and clinical data are presented at the end of the article. In 10 instances, only the briefest clinical notes are given, because these cases have been reported in detail in another connection elsewhere (1). A brief tabulation of the patients appears in Table I. Thirteen died as a direct result of the toxemia, which took an eclamptic form in 6; the other 10 died with late sequellae of the disease, which had begun with an eclamptic attack in one.