Renal artery stenosis due to fibromuscular dysplasia in an 18-week pregnant woman.

Abstract

Hypertension is a frequent medical complication of pregnancy. Renovascular hypertension is present in 5-10% of cases of severe hypertension during pregnancy. In this report we describe a 36-year-old woman with severe hypertension caused by bilateral renal artery stenosis due to fibromuscular dysplasia. Guided by the patient's ultrasound findings, only 1 side was treated with angioplasty. Continued labile blood pressure resulted in arteriography of the contralateral renal artery, which confirmed renal artery stenosis was present on the other side. Clinicians should maintain a high index of suspicion for renovascular hypertension in pregnancy when drug resistance is present. Because the potential for false-negative results with noninvasive testing for renal artery stenosis is present, if clinical suspicion is high, one should consider using invasive testing.