Bilateral renal artery stenosis due to fibromuscular dysplasia presenting as superimposed pre-eclampsia

• Published in: BMJ case reports Vol. 14; no. 5; p. e237759
• Main Authors: Munasinghe, Aruna, Wedisinghe, Lilantha, Han, Thin, Narayan, Rajit
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 26-05-2021; BMJ Publishing Group
• Subjects: Angioplasty; Angioplasty, Balloon; Atherosclerosis; Blood pressure; Case Report; Case reports; Childbirth & labor; Creatinine; Female; Fetuses; Fibromuscular Dysplasia - complications; Fibromuscular Dysplasia - diagnostic imaging; Humans; Hypertension; Hypertension, Renovascular; Kidneys; Medical imaging; Pre-Eclampsia - diagnosis; Preeclampsia; Pregnancy; Prenatal exposure; Radiation; Renal Artery Obstruction - diagnostic imaging; Renal Artery Obstruction - etiology; Smoking; Vagina; Veins & arteries; hypertension; pregnancy
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2020-237759

Renal vascular hypertension is a diagnosis that needs to be entertained in the setting of refractory, otherwise unexplained hypertension in pregnancy. Conclusive diagnosis of the condition is made by the use of angiography, which confers only a low, safe dose of radiation to the fetus, especially after the first trimester. Percutaneous angioplasty is effective in treating this condition and is best performed postnatally to avoid fetal exposure to ionising radiation. While it could be managed pharmacologically, more refractory cases in pregnancy may be offered interventional treatment.