Hematuria in pregnancy due to renal arteriovenous malformation: A case report

Autor: Ashie Kapoor, Leo Yamaguchi, Yi McWhorter, Sherwin Azad
Rok vydání: 2021
Předmět:
medicine.medical_specialty
RD1-811
MRA
magnetic resonance angiography
medicine.medical_treatment
urologic and male genital diseases
Article
Magnetic resonance angiography
Digital subtraction angiography (DSA)
Pregnancy
IR
interventional radiology
medicine
Embolization
Renal arteriovenous malformations
Emergent cystoscopy
Hematuria
Computed tomography angiography
AVM
arteriovenous malformation
DSA
digital subtraction angiography
US
ultrasound
medicine.diagnostic_test
business.industry
Coil embolization
Obstetrics and Gynecology
Arteriovenous malformation
Interventional radiology
Gynecology and obstetrics
Digital subtraction angiography
Cystoscopy
medicine.disease
ICU
intensive care unit
medicine.anatomical_structure
RG1-991
Abdomen
Surgery
CTA
computed tomography angiography
Radiology
ACOG
American College of Obstetricians and Gynecologists
business
MRI
magnetic resonance imaging
Zdroj: Case Reports in Women's Health, Vol 32, Iss, Pp e00357-(2021)
Case Reports in Women's Health
ISSN: 2214-9112
DOI: 10.1016/j.crwh.2021.e00357
Popis: A 31-year-old pregnant woman at 22 weeks and 2 days of gestation presented to the emergency room with complaints of painless hematuria and passage of clots. Initial computed tomography angiography (CTA) of the abdomen and pelvis performed after ultrasound revealed evidence of blood products in the bladder. However, the CTA did not reveal any source of bleeding. Given hemodynamic instability and persistent pain, the patient was taken to the operating room for a cystoscopy, which revealed bleeding from the left renal unit, giving rise to suspicion of a renal arteriovenous malformation (AVM). The patient then underwent left renal digital subtraction angiography (DSA), which produced no evidence of active bleeding. Due to high clinical suspicion and ongoing symptomatic hematuria, she underwent DSA a second time, which did demonstrate renal AVM bleeding, and embolization was performed. This case highlights the importance of cystoscopy in diagnosing a renal AVM in a pregnant patient despite the risks of general anesthesia during pregnancy.
Highlights • Diagnosis of renal arteriovenous malformations during pregnancy can be difficult. • A high index of suspicion is necessary to diagnose renal arteriovenous malformation. • Diagnosis and management of a woman at 22 weeks of gestation are described. • The patient subsequently had an uneventful pregnancy and delivered at term.
Databáze: OpenAIRE
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