Osler-weber-rendu pregnancy

A pregnant woman presented with hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome) and a single pulmonary arteriovenous malformation (AVM) that had been embolized 5 years previously. Partly due to pregnancy, recanalization of the aneurysm occurred with subsequent hemoptysis. Despite successful therapeutic reembolization of the afferent pulmonary artery, hemoptysis recurred 5 days later. At this time, recanalization of the pulmonary artery was not demonstrated by pulmonary angiography, but a systemic angiogram revealed a bronchial arterial supply to the pulmonary AVM...

Congenital pulmonary arteriovenous fistula is frequently associated with hereditary haemorrhagic telangiectasia (Rendu-Osler-Weber disease). With the increased blood flow in pregnancy such fistulas enlarge, occasionally giving rise to haemothorax, which generally has a poor prognosis. A familial case is presented in which massive haemothorax required emergency thoracotomy in the 27th week of pregnancy.

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The authors report on the case of a young woman, seven months gone, with an history of sudden onset of successive lobar intracerebral hematomas. They revealed a Rendu-Osler-Weber disease. The mechanism is discussed.

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Several reports have implicated pregnancy as a cause of deterioration in patients with pulmonary arteriovenous fistulas. We report a 27-year-old woman with multiple pulmonary arteriovenous fistulas who required coil spring embolotherapy in her 24th week of pregnancy due to a spontaneous hemothorax and hypoxemia.

We report a postmature male infant who died at age 2 h of asphyxiating pulmonary hemorrhage. Autopsy found edema, serous ascites, and vascular malformations within myocardium, lung, mediastinal soft tissue, thoracic-wall skeletal muscle, spleen, thyroid and adrenal glands, and pancreas. The pulmonary malformations had arteriovenous features, while those elsewhere were predominantly capillary; many of the latter contained fibrinous thrombi. Circulating nucleated erythrocytes, siderosis of proximal renal tubular epithelium, and intrahepatocytic and intracanalicular cholestasis were present...

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