Korn T S, Thurston J M, Sherry C S, Kawalsky D L
Department of Internal Medicine, Presbyterian Hospital of Dallas, Texas, USA.
Mayo Clin Proc. 1998 Sep;73(9):888-92. doi: 10.4065/73.9.888.
A 29-year-old nulliparous woman had development of hypertension, proteinuria, and congestive heart failure during the third trimester of her pregnancy. Her symptoms and cardiovascular changes were consistent with congestive heart failure and severe preeclampsia. The underlying pathophysiology was believed to be caused by the high-output state of pregnancy and by the increased peripheral vascular resistance of preeclampsia. The patient underwent an elective cesarean section, but her cardiovascular symptoms did not resolve. Soon after delivery, the patient was found to have an arteriovenous fistula of the right renal artery that caused the high-output cardiac state. Embolization and surgical removal of the arteriovenous fistula resulted in complete resolution of the patient's high-output heart failure. All previously reported cases of renal arteriovenous fistulas and malformations that have occurred during pregnancy are reviewed.
一名29岁未生育女性在妊娠晚期出现高血压、蛋白尿和充血性心力衰竭。她的症状和心血管变化符合充血性心力衰竭和重度子痫前期。据信潜在的病理生理机制是由妊娠的高输出状态以及子痫前期外周血管阻力增加所致。患者接受了择期剖宫产，但心血管症状并未缓解。产后不久，发现患者右肾动脉存在动静脉瘘，导致高输出心脏状态。动静脉瘘的栓塞和手术切除使患者的高输出心力衰竭完全缓解。本文回顾了所有先前报道的妊娠期间发生的肾动静脉瘘和畸形病例。
