Spontaneous Adrenal Hemorrhage in Pregnancy: A Case Series.

Ankita Gupta,Ruby Minhas,Hayley S Quant

doi:10.1155/2017/3167273

Ankita Gupta, Ruby Minhas + Show 1 more

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https://doi.org/10.1155/2017/3167273

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Abstract

Background. Abdominal pain during pregnancy has a broad differential diagnosis which includes spontaneous adrenal hemorrhage (SAH). There is scant literature available on optimal mode of delivery in stable patients. Cases. Patient 1 was a 35-year-old nullipara who presented at 36 weeks of gestation with left flank pain. Patient 2 was a 27-year-old multipara at 38 weeks who presented with left upper quadrant pain. Diagnosis of SAH was made by CT scan and both were managed with pain control, serial hemoglobin assessments, and abdominal exams resulting in uncomplicated vaginal deliveries. Conclusion. SAH, although rare, is an important consideration when evaluating abdominal and flank pain in pregnancy. Management options vary from conservative management to surgical intervention depending on the stability of the patient.

Highlights

Abdominal pain, a common complaint during pregnancy, has a broad differential diagnosis which includes spontaneous adrenal hemorrhage (SAH)
SAH can lead to adrenal crisis and shock necessitating emergency laparotomy and adrenalectomy [2, 5]
We present two cases of symptomatic SAH in the third trimester of pregnancy with successful conservative management

Summary

Background

Abdominal pain during pregnancy has a broad differential diagnosis which includes spontaneous adrenal hemorrhage (SAH). There is scant literature available on optimal mode of delivery in stable patients. Patient 1 was a 35-year-old nullipara who presented at 36 weeks of gestation with left flank pain. Patient 2 was a 27-year-old multipara at 38 weeks who presented with left upper quadrant pain. Diagnosis of SAH was made by CT scan and both were managed with pain control, serial hemoglobin assessments, and abdominal exams resulting in uncomplicated vaginal deliveries. SAH, rare, is an important consideration when evaluating abdominal and flank pain in pregnancy. Management options vary from conservative management to surgical intervention depending on the stability of the patient

Introduction

Case Presentation

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Conclusion