RESUMO
The incidence of renal angiomyolipoma (RA) is 0.3% in the general population, and even more infrequent during pregnancy. Pregnancy can increase the risk of rupture, although the causal mechanism is still not clearly defined. We completed a Medline literature search for articles on RA and pregnancy and its complications. We identified 16 articles (all case reports), but selected only 13 because of unavailable data in the 3 other articles. We report the case of a 30-year-old primiparous woman who presented at the emergency ward with a non-reassuring pattern at fetal monitoring; an urgent cesarean section was decided and carried out. After surgery, a wide retroperitoneal hematoma was observed caused by the rupture of an RA. Conservative management by means of arterial embolism was done and the patient was discharged on postoperative day 10. RAs seem to have a higher risk of rupture during pregnancy, but they should be managed conservatively when hemodynamically possible. Individualization of each case is necessary in order to achieve the best outcome for both the mother and fetus.
Assuntos
Angiomiolipoma/patologia , Neoplasias Renais/patologia , Complicações Neoplásicas na Gravidez , Adulto , Angiomiolipoma/diagnóstico por imagem , Angiomiolipoma/terapia , Embolização Terapêutica , Feminino , Hematoma/diagnóstico , Hematoma/terapia , Humanos , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/terapia , Doenças Peritoneais/diagnóstico , Doenças Peritoneais/terapia , Gravidez , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: The Nutcracker syndrome (mesoaortic compression of the left renal vein) is a rare condition which causes macroscopic hematuria and colic pain. METHODS: We have carried out a search in Medline database of the current trends in the management of this rare syndrome during pregnancy. RESULTS: We found four reports on diagnosis of the syndrome during pregnancy but there is no published articles concerning the management of pregnancy after diagnosis of a Nutcracker syndrome treated with a vascular stent. A case of Nutcracker's syndrome during pregnancy is reported as well as a review of the clinical findings and management of the syndrome. CONCLUSION: The pregnancy of patients with Nutcracker syndrome, undergone vascular stent placement, should be considered high risk gestation and should be managed with low molecular weight heparin and serial renal vein flow Doppler studies.
Assuntos
Doenças Vasculares Periféricas/terapia , Complicações Cardiovasculares na Gravidez/terapia , Veias Renais/patologia , Adulto , Constrição Patológica/terapia , Feminino , Hematúria/etiologia , Hematúria/patologia , Hematúria/terapia , Humanos , Doenças Vasculares Periféricas/complicações , Doenças Vasculares Periféricas/patologia , Gravidez , Complicações Cardiovasculares na Gravidez/patologia , Cólica Renal/etiologia , Cólica Renal/patologia , Cólica Renal/terapia , SíndromeAssuntos
Obstrução Intestinal/epidemiologia , Obstrução Intestinal/etiologia , Divertículo Ileal/complicações , Abdome Agudo/epidemiologia , Abdome Agudo/etiologia , Abdome Agudo/cirurgia , Adulto , Feminino , Humanos , Obstrução Intestinal/cirurgia , Divertículo Ileal/cirurgia , Gravidez , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/etiologia , Complicações na Gravidez/cirurgia , Resultado da Gravidez , Terceiro Trimestre da Gravidez , Resultado do TratamentoRESUMO
Postpartum spontaneous pneumomediastinum (Hamman's syndrome) is a very rare event with an estimated incidence of 1 in 100,000 deliveries. It occurs mainly in the second stage of labor and is potentially lethal. We report the case of a 29-year-old primiparous woman during the immediate puerperium (Leff's fourth stage of labor) presenting with acute chest pain, dyspnea and petechiae. She was admitted to the intensive care unit with a suspected diagnosis of amniotic fluid embolism. A chest radiograph revealed a pneumomediastinum that finally resolved with oxygen therapy and supportive management in 3 days.
