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.


METHODS
Physical examination, laboratory investigation, renal angiogram and renal-vein renin sampling.


METHODS
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.


RESULTS
Right nephrectomy and angioplasty of the left renal artery.
Thorsteinsdottir
Bjorg
B
Community Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Kane
Garvan C
GC
Hogan
Michael J
MJ
Watson
William J
WJ
Grande
Joseph P
JP
Garovic
Vesna D
VD
D000028:Abortion, Induced; D000328:Adult; D000792:Angiography; D017130:Angioplasty; D001284:Atrophy; D005260:Female; D005313:Fetal Death / Q000209:etiology*; D005352:Fibromuscular Dysplasia / Q000150:complications; D006801:Humans; D006978:Hypertension, Renovascular / Q000150:complications* / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D007674:Kidney Diseases / Q000209:etiology / Q000473:pathology / Q000601:surgery; D009392:Nephrectomy; D049590:Postpartum Period; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000503:physiopathology*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000209:etiology / Q000503:physiopathology; D012078:Renal Artery Obstruction / Q000150:complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D012082:Renal Veins; D012083:Renin / Q000097:blood
D012083:Renin