Abstract
A 27 year-old woman, gravida 1, para 1, was admitted at 25 weeks' gestation for macroscopic hematuria and fever. Her white blood cell count was 25, 190/mm3, red blood cell count was 250±104/mm3, and hemoglobin was 7.0g/dl. Ultrasonographic examination and MRI images presented hemorrhagic tumor of the right kidney. As conservative therapies were ineffective, an angiography was operated. First angiography revealed a right sided renal arteiovenous malformation. A TAE with sponzel was performed, but it failed and rebleeding from residual fistulas was occured.
The second angiography, which was operated 2 days after the previous angiography, revealed re-sidual fistulas, and an additional TAE with stainless steel coil was performed. Renal bleeding was stopped and anemia was gradually improved. The fetal growth was not restricted and no anomalies were seen at ultrasonographic examination. The patient deliverd a full-term healthy neonate at 38 weeks' gestation. Her puerperial course was un-eventful and renal function was normal.
As a good result has been achieved, it is assumed that even in the pregnant case, TAE could be the first indication for treatment of renal arteriovenous malformation.
