Abstract
BackgroundRenal artery aneurysms (RAAs) in pregnancy are uncommon, with most found after rupturing. The risk of RAA rupture increases during pregnancy and delivery.Case presentationA 29-year-old woman at 36 weeks and 5 days of gestation presented with severe back and abdominal pain. No fetal movements were identified. Cesarean section (C/S) was performed due to severe fetal bradycardia. No signs of placental abruption or abnormalities of the placenta were apparent intraoperatively, but gross hematoma was identified intraoperatively in the left retroperitoneal space. To evaluate persistent hypotension and retroperitoneal hematoma, contrast-enhanced computed tomography was performed and revealed ruptured RAA in the left kidney. Transcatheter arterial embolization (TAE) was performed.ConclusionsThis case report describes fetal dysfunction caused by RAA rupture and controlled by TAE.
Highlights
Renal artery aneurysms (RAAs) in pregnancy are uncommon, with most found after rupturing
We reported a case of emergency cesarean section due to fetal bradycardia of unknown origin, which turned out to be caused by renal artery aneurysm rupture
Retroperitoneal hematoma was found intraoperatively and turned out to be caused by the rupture of a RAA. This case was rare and unique, in that RAA rupture in a pregnant woman was the cause of prolonged hypotension and retroperitoneal hematoma
Summary
Background Renal artery aneurysms (RAAs) in pregnancy are uncommon, with most found after rupturing. RAA occupy approximately 0.01% of VAA and there are only 32 cases reported over the past 20 years [4], over 50% of ruptured RAAs under 40 years old are reportedly related to pregnancy [5]. We reported a case of emergency cesarean section due to fetal bradycardia of unknown origin, which turned out to be caused by renal artery aneurysm rupture.
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