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.


METHODS
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.


CONCLUSIONS
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.
Cohen
Debbie L
DL
Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA. cohendl@mail.med.upenn.edu
Townsend
Raymond R
RR
Clark
Timothy W I
TW
D000328:Adult; D000792:Angiography / Q000379:methods; D000800:Angioplasty, Balloon / Q000379:methods*; D005260:Female; D005352:Fibromuscular Dysplasia / Q000150:complications / Q000175:diagnosis*; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis* / Q000628:therapy; D011256:Pregnancy Outcome; D012078:Renal Artery Obstruction / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy*; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal; D014654:Vascular Patency