Nature clinical practice. Nephrology · 2006
Adverse outcomes of renovascular hypertension during pregnancy.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Thorsteinsdottir Bjorg, Kane Garvan C, Hogan Michael J, Watson William J, Grande Joseph P, Garovic Vesna D
Аннотация
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.
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.