Massive hemoptysis in pregnancy treated with bronchial artery embolization.

Abstract

Massive hemoptysis is a life-threatening situation that rarely complicates pregnancy. Presented is a case of massive hemoptysis during pregnancy, which was successfully diagnosed and treated with bronchial artery angiogram and embolization. A 26-year-old multigravida at 19 weeks' gestational age with a history of intravenous substance abuse and infective endocarditis presented with hemoptysis. Extensive workup, including bronchoscopy, echocardiography, and magnetic resonance pulmonary angiography were negative. The patient left the hospital against medical advice to return 4 weeks later with massive hemoptysis. Bronchial arteriography revealed multiple areas of potential bleeding in the right and left lower lobes. Bilateral bronchial artery embolization was performed. The patient carried the pregnancy to term with no further episodes of hemoptysis. Hemoptysis during pregnancy requires a thorough workup and prompt treatment if the etiology is diagnosed. When faced with massive hemoptysis, the obstetrician should strongly consider bronchial artery angiography and embolization.