1. Ruptured pulmonary arteriovenous malformation during pregnancy
- Author
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Alyssa S. W. Wong, Wing Hung Tam, G. W. Y. Cheung, Simon Ch Yu, Innes Y.P. Wan, Anthony P.C. Yim, Anthony V. Manlulu, and Ming Chi Chu
- Subjects
Adult ,medicine.medical_specialty ,Cardiac output ,Pregnancy Trimester, Third ,Population ,Pregnancy Complications, Cardiovascular ,Blood volume ,Pulmonary Artery ,Arteriovenous Malformations ,Diagnosis, Differential ,Pregnancy ,Internal medicine ,Prenatal Diagnosis ,medicine ,Humans ,education ,Emergency Treatment ,Hemothorax ,education.field_of_study ,Rupture, Spontaneous ,business.industry ,Vascular disease ,Thoracic Surgery, Video-Assisted ,Obstetrics and Gynecology ,Prenatal Care ,General Medicine ,medicine.disease ,Surgery ,Radiography ,Pulmonary Veins ,Cardiology ,Gestation ,Female ,Pulmonary hemorrhage ,business - Abstract
Pulmonary arteriovenous malformation (PAVM) during pregnancy is a rare condition. There were 34 cases reported in the literature of which three were fatal. The major cause of death was pulmonary hemorrhage. Physiological changes during pregnancy can worsen PAVM and can increase its risk of hemorrhage. The mechanism can be twofold. High estrogen and progesterone levels during pregnancy lead to venous distensibility and hence trigger the growth of PAVM whereas the increase in blood volume and cardiac output could raise the pulmonary blood flow and could cause dilatation and rupture of the thin-walled vessels. This explains that the majority of the hemorrhage occurs during the second and third trimesters when blood volume and cardiac output increased to their maximum. We describe a case of hemothorax as a result of ruptured PAVM and discuss its management during pregnancy. (excerpt)
- Published
- 2006