ABSTRACT: A 26-year-old primigravida, with no history of hypertension, presented at 20 weeks of gestation with severe pre-eclampsia. A pelvic ultrasound revealed intrauterine fetal death, probably caused by placental abruption. The pregnancy was terminated by induction with oxytocin, followed by a vaginal breech delivery. The patient remained hypertensive for 8 weeks after delivery.
Physical examination, laboratory investigation, renal angiogram and renal-vein renin sampling.
An atrophic right kidney secondary to an occluded right renal artery, probably caused by dissected fibromuscular dysplasia; a contralateral high-grade stenosis secondary to fibromuscular dysplasia.
Right nephrectomy and angioplasty of the left renal artery.
Nature Clinical Practice Nephrology 12/2006; 2(11):651-6. · 6.08 Impact Factor