因特发性肾动脉动脉瘤破裂导致胎儿功能障碍而行剖宫产术。

Cesarean section following idiopathic rupture of renal artery aneurysm leading to fetal dysfunction.

作者信息

Matsuoka Misa, Suto Takashi, Hio Sayaka, Saito Shigeru

机构信息

Department of Anesthesiology, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi-shi, Gunma, 371-8511, Japan.

Department of Anesthesiology, Gunma University Graduate School of Medicine, 3-39-22, showa-machi, Maebashi-shi, Gunma, 371-8511, Japan.

出版信息

JA Clin Rep. 2019 Mar 6;5(1):17. doi: 10.1186/s40981-019-0237-y.

DOI:10.1186/s40981-019-0237-y

PMID:32025971

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6967259/

Abstract

BACKGROUND

Renal artery aneurysms (RAAs) in pregnancy are uncommon, with most found after rupturing. The risk of RAA rupture increases during pregnancy and delivery.

CASE PRESENTATION

A 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.

CONCLUSIONS

This case report describes fetal dysfunction caused by RAA rupture and controlled by TAE.

摘要

背景

妊娠期间肾动脉动脉瘤（RAA）并不常见，多数在破裂后才被发现。妊娠和分娩期间RAA破裂的风险会增加。

病例报告

一名妊娠36周零5天的29岁女性出现严重的背部和腹痛。未检测到胎儿活动。因严重胎儿心动过缓而行剖宫产（C/S）。术中未发现胎盘早剥或胎盘异常的迹象，但术中在左腹膜后间隙发现了巨大血肿。为评估持续性低血压和腹膜后血肿，进行了对比增强计算机断层扫描，结果显示左肾RAA破裂。遂进行了经导管动脉栓塞术（TAE）。