The kidneys show a well preserved lobular structure with indistinct corticomedullary demarcation (Image 01). Poorly oriented tubules are dispersed throughout the cortex. They are primitive and lined by poorly differentiated columnar and cuboidal cells, lacking the features of proximal convoluted tubules (Image 02) as compared with a normal kidney at the same gestational age (Image 03). Immunoperoxidase staining with epithelial membrane antigen (EMA), a marker of normal distal tubular and collecting duct epithelium is positive in all tubular structures (image 04). A large macula densa is present with the same staining pattern (image 05). Multiple renal vein thrombosis of varying ages, some old with calcifications are see in the renal hilum but not in the renal parenchyma. Sections of the placenta show villous maturation advanced for gestational age, recent vascular thromb in the chorionic plate (Image 06) and decidual vasculopathy (Image 06).