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首页> 外文期刊>Case Reports in Obstetrics and Gynecology >Pulmonary Arteriovenous Malformations (PAVMs) and Pregnancy: A Rare Case of Hemothorax and Review of the Literature
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Pulmonary Arteriovenous Malformations (PAVMs) and Pregnancy: A Rare Case of Hemothorax and Review of the Literature

机译：肺动脉畸形（Pavms）和怀孕：罕见的血腥案例和对文献的审查

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Pulmonary arteriovenous malformations (PAVMs) are anatomical abnormalities consisting in a direct connection between pulmonary arteries and veins. Most of PAVMs are related to Hereditary Hemorrhagic Teleangiectasia, whereas only 10 to 20% are isolated sporadic cases. PAVMs tend to increase in size naturally; however, several factors can influence their growth such as pulmonary arterial hypertension, puberty, and pregnancy. Clinical manifestations are related to the right-to-left shunting and include dyspnoea, hypoxia, and pulmonary hypertension. The presence of PAVMs during pregnancy is associated with an increased risk of complications such as their rupture, haemothorax, and hypovolemic shock. The treatment reserved to PAVMs was the surgical resection of the lung lobe involving the malformation. Due to the worldwide acceptance of endovascular technique, the transcatheter embolization (TCE) is today considered as the mainstay of treatment. Recent studies reported the safeness of the TCE during pregnancy if performed by an experienced radiologist, at second or third trimesters when radiation exposure is believed to have minimal effect on the foetus. However, although the TCE during pregnancy represents an option, the treatment prior to pregnancy has to be considered the auspicial solution. Our study reports the case of a dyspnoeic pregnant woman with unknown pAVM causing hemothorax and simultaneously treated for pAVM reparation, left lower lobe resection, and hysterectomy. Postoperative treatment of embolization was performed to definitively close the pAVM.
机译：肺动脉畸形（Pavms）是肺动脉和静脉之间直接连接的解剖学异常。大多数Pavms与遗传性出血性Teleangiectasia有关，而仅10至20％是隔离散发性案例。 Pavms倾向于自然地增加;然而，若干因素可以影响其肺动脉高血压，青春期和怀孕等生长。临床表现与左右分流有关，包括呼吸困难，缺氧和肺动脉高压。妊娠期间的蜂巢的存在与并发症的风险增加有关，例如它们的破裂，血汁和缓血休克。保留给Pavms的治疗是涉及畸形的肺叶的手术切除。由于全世界接受血管内技术，经转沟管栓塞（TCE）今天被认为是治疗的主要支柱。最近的研究报告说，如果由经验丰富的放射科医生，在辐射暴露时经历过的放射科医师进行的，则怀孕期间的安全性在辐射暴露于胎儿对胎儿产生最小的影响时。然而，虽然怀孕期间的TCE代表一种选择，但怀孕前的治疗必须被认为是自身的解决方案。我们的研究报告了具有未知PAVM的令人讨厌的孕妇的案例，导致血管痉挛，同时治疗PAVM恢复，左下叶切除和子宫切除术。术后处理栓塞的术语以明确地关闭帕米。

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