AbstractsMedical & Health Science

In 1933 Walter de M. Scriver and Horst Oertel of McGill University reported three occurrences of a condition which they termed, "Necrotic Sequestration of the Kidneys in Pregnancy (Symmetrical Cortical Necrosis)"(l). In the same report they included a review of the literature dealing with the condition. Scriver described it as a comparatively clear-cut clinical entity, the outstanding features being anuria or oliguria and marked azotemia, the picture resembling that seen in bilateral obstruction of the ureters. The literature reviewed included isolated instances occurring during the course of infectious diseases (diphtheria, pulmonary tuberculosis, dysentery, pneumonia and peritonitis), but by far the majority of cases occurred in females following an accident of pregnancy, usually a retroplacental hemorrhage occurring from the fourth month to full term. Oertel emphasised cortical necrosis identified with bland or anemic infarction as the essential part of the pathological process. He agreed with most previous investigators in believing the necrosis to be caused by thrombosis of the interlobular vessels. He did not believe that the thrombosis followed vascular spasm and suggested that it was due to a stagnation of the blood in response to tissue irritation, a process described by Ricker and his school(2). He suggested that a "paralytic terminal segmentary circulatory downfall" was in some way related to a "general abnormal state of vasomotor irritability of the pregnant [...]