Prabulos A M, Chen H H, Rodis J F, Ruby S, Campbell W A
Department of Obstetrics and Gynecology, University of Connecticut Health Center, Farmington, USA.
Obstet Gynecol. 1997 Oct;90(4 Pt 2):663-5. doi: 10.1016/s0029-7844(97)00258-5.
Ruptured arterial aneurysms during pregnancy usually are catastrophic, and the primary approach is surgical. Angiographic embolization is an alternative treatment.
A 28-year-old primigravida with a history of congenital hepatic fibrosis presented at 23 weeks' gestation with abdominal pain, hypertension, and proteinuria. She underwent a cesarean delivery for preeclampsia and a retroperitoneal hematoma was noted. A postoperative angiogram revealed bilateral renal artery and splenic aneurysms. She underwent two angiographic embolizations of a ruptured right renal artery aneurysm and was discharged to undergo outpatient embolotherapy of the left renal and splenic aneurysms. The day after discharge, she died because of rupture of the splenic aneurysm.
Aggressive management of ruptured and high-risk unruptured aneurysms during pregnancy is indicated. Embolotherapy is an alternate approach if surgery is not possible.
妊娠期动脉动脉瘤破裂通常是灾难性的，主要治疗方法是手术。血管造影栓塞是一种替代治疗方法。
一名28岁初产妇，有先天性肝纤维化病史，孕23周时出现腹痛、高血压和蛋白尿。她因先兆子痫接受了剖宫产，术中发现腹膜后血肿。术后血管造影显示双侧肾动脉和脾动脉瘤。她接受了两次针对破裂的右肾动脉瘤的血管造影栓塞治疗，出院后接受左肾和脾动脉瘤的门诊栓塞治疗。出院后第二天，她因脾动脉瘤破裂死亡。
妊娠期应积极处理破裂和高危未破裂动脉瘤。如果无法进行手术，栓塞治疗是一种替代方法。
