title: [A pregnant patient with spontaneous haemothorax: hereditary haemorrhagic telangiectasia in pregnancy].
abstract: The incidence of hereditary haemorrhagic telangiectasia (HHT - Osler-Weber-Rendu disease) in the Netherlands is 1:5000 but approximately 1:1300 in people from the Antilles. The disease is characterised by the development of telangiectasia and arteriovenous malformations (AVMs) that may result in serious morbidity and mortality.
  
  
  
  A 31-year-old primigravid patient consulted her general practitioner at 31 1/7 weeks gestational age with dyspnoea. She was referred for further diagnostics because of suspected pulmonary embolism. A CT scan showed haemothorax and a bleeding arteriovenous malformation (AVM) in the left lung. Family history suggested the possibility of HHT. After multidisciplinary consideration, a primary caesarean section was performed, followed by embolisation of the AVM during the same surgical session. The patient had a gene mutation consistent with HHT type 2.
  
  
  
  Pregnant patients with HHT are at risk of serious morbidity, especially if they are not screened for AVMs. A multidisciplinary approach for such patients, with consideration of various scenarios, is highly recommended.
authors.affiliation: Radboudumc, Nijmegen.
authors.forename: S M
authors.initials: SM
authors.lastname: Mourad
authors.forename: R
authors.initials: R
authors.lastname: Mies
authors.forename: T
authors.initials: T
authors.lastname: Frenzel
authors.forename: S
authors.initials: S
authors.lastname: Willems
authors.forename: E
authors.initials: E
authors.lastname: van der Heijden
authors.forename: L J
authors.initials: LJ
authors.lastname: Schultze Kool
mesh_terms: D000328:Adult; D001165:Arteriovenous Malformations / Q000235:genetics*; D005260:Female; D005865:Gestational Age; D006491:Hemothorax / Q000235:genetics*; D006801:Humans; D008168:Lung / Q000098:blood supply; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000235:genetics*; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000150:complications* / Q000235:genetics; D014057:Tomography, X-Ray Computed