Ruptured Renal Artery Aneurysm in a Pregnant Woman: Case Report and Literature Review

Abstract

Renal artery aneurysms (RAAs) are rare and usually asymptomatic; ∼ 90% of them are unilateral. Once diagnosed during pregnancy, they may rupture, presenting a high maternal-fetal risk. The present study reports the case of a 32-year-old pregnant woman with a 30-week gestational age and a ruptured unilateral RAA.

Renal Arteriovenous Fistulas during Pregnancy: Diagnosis and Treatment

“…However, the stent was later removed due to acute retention and presence of clots in the urinary system. Persistent pelvic dilatation (26mm) and clots necessitated the placement of a nephrostomy which was performed under ultrasound guidance to avoid any radiation exposure [1,2]. The patient's hemoglobin levels continued to decrease, and there was frank hematuria from the nephrostomy tube, raising suspicion of a parenchymal arteriovenous fistula (FAV).…”

“…It was able to reveal an increase in parenchymal vascularization (obstruction) and small arteriovenous fistula (6mm) at the medial-third with arteriovenous flows and low resistance (Figures 1, 2). Since US was able to provide detailed images of vascular system, size, and localization of the fistula, a magnetic resonance (MRI) was not considered necessary due to the urgency of the case [1].…”

“…Nephrectomy was an option; however, due to the advanced stage of pregnancy, the potential harm from a minimally invasive radiation procedure was deemed to be greater than in the first three months [1]. She underwent super-selective embolization of the FAV via inguinal access, with a DAP 18.8Gycm2 delivered to the patient.…”

“…It does not use ionizing radiation and can provide detailed images of the vascular system. In some cases, a diagnostic angiogram may be necessary to confirm the diagnosis of an AVF [1].…”

“…Only a few case series have reported successful outcomes with radiologic embolization, and there is limited data on the safety and efficacy of this procedure. In general, http://dx.doi.org/10.51521/WJCRCI.2024.31-225 ISSN: 2835-1568; CODEN: USA embolization is reserved for cases where conservative management has failed, with significant maternal or fetal morbidity or mortality risk [1]. Individualized treatment, based on the patient's clinical conditions is essential.…”