Conservative management of a retroperitoneal hemorrhage following a ruptured renal angiomyolipoma in pregnancy


Gyimadu A. O. , Kara O., BAŞARAN D. , ESİNLER İ.

JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH, vol.37, no.2, pp.156-159, 2011 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 37 Issue: 2
  • Publication Date: 2011
  • Doi Number: 10.1111/j.1447-0756.2010.01326.x
  • Title of Journal : JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH
  • Page Numbers: pp.156-159

Abstract

Retroperitoneal hemorrhage following ruptured renal angiomyolipoma is usually managed surgically or by embolization. But when the same episode occurs in pregnancy, surgery which predisposes to preterm delivery and its subsequent sequelae, the unknown influences of radiation exposure on the fetus makes the management of such cases very challenging. A 21-year-old woman was seen in the emergency unit at the 25th week of her pregnancy with complaints of sudden onset left flank pain radiating to the back, nausea and hematuria. Abdominal magnetic resonance imaging (MRI) revealed masses consistent with angiomyolipoma in the upper pole of the left kidney with evidence of recent bleeding and the center of the right kidney measuring 11.5 x 9.5 cm and 3.5 cm, respectively. The patient received three units of red blood cell concentrate due to fall in hematocrit level resulting in hemodynamically stable condition until term. At term, an infant weighing 3510 g was delivered through elective cesarean section. To avoid iatrogenic preterm delivery and unnecessary fetal exposure to radiation, conservative management of ruptured angiomyolipoma in pregnancy may be considered as a treatment option in hemodynamically stable patients.