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Ruptured renal artery aneurysm during pregnancy
Annals of Vascular Surgery
|July 1, 1996
Summary
Pregnancy increases the risk of renal artery aneurysms (RAAs) rupturing. This case highlights a rare second-trimester rupture, necessitating nephrectomy and emphasizing diagnostic considerations for pregnant women.
Area of Science:
- Vascular Surgery
- Obstetrics & Gynecology
- Radiology
Background:
- Renal artery aneurysms (RAAs) are rare vascular lesions.
- Pregnancy is a known risk factor for RAA rupture, particularly in later trimesters.
- Ruptured RAAs historically carried high maternal and fetal mortality rates.
Observation:
- A 38-year-old pregnant woman presented with unexplained hemorrhage.
- Arteriography revealed a large right RAA and a small left RAA.
- The fetus had already expired; emergency right nephrectomy was performed due to unreparable aneurysm.
Findings:
- This case represents a rare instance of RAA rupture during the second trimester of pregnancy.
- Despite advances, preoperative diagnosis of ruptured RAAs remains challenging.
- Surgical repair of RAAs during pregnancy is often not feasible, with nephrectomy being a necessary intervention.
Implications:
- Clinicians should consider ruptured RAAs in pregnant patients with unexplained hemorrhage.
- Prompt diagnosis and management are crucial for maternal survival.
- Further research into optimal surgical techniques and management strategies for RAAs in pregnancy is warranted.