1/8. renal artery stenosis due to fibromuscular dysplasia in an 18-week pregnant woman.BACKGROUND: hypertension is a frequent medical complication of pregnancy. Renovascular hypertension is present in 5-10% of cases of severe hypertension during pregnancy. CASE: In this report we describe a 36-year-old woman with severe hypertension caused by bilateral renal artery stenosis due to fibromuscular dysplasia. Guided by the patient's ultrasound findings, only 1 side was treated with angioplasty. Continued labile blood pressure resulted in arteriography of the contralateral renal artery, which confirmed renal artery stenosis was present on the other side. CONCLUSION: Clinicians should maintain a high index of suspicion for renovascular hypertension in pregnancy when drug resistance is present. Because the potential for false-negative results with noninvasive testing for renal artery stenosis is present, if clinical suspicion is high, one should consider using invasive testing.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/8. Adverse outcomes of renovascular hypertension during pregnancy.BACKGROUND: A 26-year-old primigravida, with no history of hypertension, presented at 20 weeks of gestation with severe pre-eclampsia. A pelvic ultrasound revealed intrauterine fetal death, probably caused by placental abruption. The pregnancy was terminated by induction with oxytocin, followed by a vaginal breech delivery. The patient remained hypertensive for 8 weeks after delivery. INVESTIGATIONS: physical examination, laboratory investigation, renal angiogram and renal-vein renin sampling. diagnosis: An atrophic right kidney secondary to an occluded right renal artery, probably caused by dissected fibromuscular dysplasia; a contralateral high-grade stenosis secondary to fibromuscular dysplasia. MANAGEMENT: Right nephrectomy and angioplasty of the left renal artery.- - - - - - - - - - ranking = 1.6666666666667keywords = pregnancy (Clic here for more details about this article) |
3/8. renal artery stenosis during pregnancy: a review.renal artery stenosis in pregnancy may present as chronic hypertension with superimposed preeclampsia or as recurrent isolated preeclampsia. Renal angiography is the most sensitive and specific diagnostic technique available for this lesion, and therapeutic percutaneous transluminal angioplasty may be carried out in conjunction with angiography. We report a patient with renal artery stenosis diagnosed and treated with percutaneous transluminal angioplasty at 26 3/7 weeks gestation. The literature on renal artery stenosis in pregnancy is reviewed.- - - - - - - - - - ranking = 2keywords = pregnancy (Clic here for more details about this article) |
4/8. Renal vascular hypertension during pregnancy.We report two women with renal artery stenosis in pregnancy. The first patient presented with severe hypertension in the first and second trimesters characterized by an extremely high vascular resistance (maximum 2455 dyne.second.cm-5). Transluminal angioplasty was performed at 20 weeks' gestation, resulting in resolution of the patient's hypertension. After angioplasty, her vascular resistance fell to 1600 dyne.second.cm-5, but did not reach normal pregnant levels. The pregnancy was carried to term without complication. The second patient's hypertension improved during pregnancy, and she delivered at term without complication. Twelve weeks postpartum, the patient again became severely hypertensive, and transluminal angioplasty was performed.- - - - - - - - - - ranking = 2.3333333333333keywords = pregnancy (Clic here for more details about this article) |
5/8. hypertension due to renal artery stenosis in pregnancy--the use of angioplasty.The use of transluminal percutaneous renal angioplasty for severe hypertension in the second trimester of pregnancy has not previously been reported. We describe its use in a 19-year-old female. The procedure resulted in a significant improvement in blood pressure control and allowed the pregnancy to proceed to term, resulting in the delivery of a normal female baby on the 90th percentile for weight. No morbidity to mother or fetus was observed as a result of diagnostic or therapeutic procedures. We conclude that pregnancy should not preclude making the diagnosis of renovascular hypertension as angioplasty may be a useful therapeutic option.- - - - - - - - - - ranking = 2.3333333333333keywords = pregnancy (Clic here for more details about this article) |
6/8. prognosis for pregnancy after correction of renovascular hypertension.renal artery stenosis was diagnosed in 3 women when hypertension of pregnancy persisted beyond the puerperium; all had poor obstetric histories and 2 had been hypertensive in the first trimester. A fourth case presented as hypertension associated with oral contraceptive use. After corrective procedures 6 further pregnancies were embarked upon, all of them successful and with only minor hypertensive complications in 2. renal artery stenosis is an important cause of pregnancy hypertension persisting after the puerperium, since its correction greatly improves the prognosis for future pregnancies.- - - - - - - - - - ranking = 2keywords = pregnancy (Clic here for more details about this article) |
7/8. Transluminal angioplasty for renovascular hypertension complicated by pregnancy.Percutaneous transluminal angioplasty was successfully used in the treatment of renovascular hypertension that resulted from fibromuscular hyperplasia in a 26-year-old woman who was four weeks' pregnant. The patient's BP normalized immediately. She had a normal pregnancy that terminated in the delivery of a full-term normal child. Two and a half years after the procedure, she remained normotensive without taking antihypertensive medication. Percutaneous transluminal angioplasty may be useful in the treatment of renal artery stenosis complicated by hypertension and pregnancy, where the inherent risk of toxemia endangers the life of the mother and fetus.- - - - - - - - - - ranking = 2keywords = pregnancy (Clic here for more details about this article) |
8/8. Endovascular stent placement and magnetic resonance angiography for management of hypertension and renal artery occlusion during pregnancy.BACKGROUND: Severe renovascular hypertension carries serious maternal and fetal risk. In patients failing medical therapy, therapeutic options include surgical revascularization, nephrectomy, and percutaneous angioplasty. CASE: A pregnant woman with long-standing hypertension developed accelerated hypertension despite multiple drug therapy. magnetic resonance angiography diagnosed an atrophic kidney with a critical proximal right renal artery lesion. At 17 weeks' gestation, this renal artery occlusion was treated with percutaneous angioplasty and endovascular stent placement; hypertension has improved markedly, allowing discontinuation and tapering of her antihypertensive medications. Total fetal radiation dose was 0.002 Gy. CONCLUSION: magnetic resonance angiography is a promising, noninvasive diagnostic method of evaluating renovascular hypertension during pregnancy. Transluminal angioplasty and endovascular stent placement can be performed safely and effectively with nominal fetal radiation exposure.- - - - - - - - - - ranking = 1.6666666666667keywords = pregnancy (Clic here for more details about this article) |