When the Uterus Competes for Perfusion: Management of a Pregnant Patient with Bypass Graft Occlusion

Background. Peripheral arterial disease (PAD) in pregnancy has serious implications and requires multidisciplinary management. This becomes even more complicated in the setting of active disease and history of prior vascular grafts. Case. A woman presented with increasing left lower extremity pain a...

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Bibliographic Details
Published in:Case reports in obstetrics and gynecology 2019, Vol.2019 (2019), p.1-4
Main Authors: Mills, Joseph L., Mendez-Figueroa, Hector, Sosa, Iberia, Percer, Paige, McGriff, Sarah, Gandhi, Manisha
Format: Article
Language:English
Subjects:
Aspirin
Case Report
Case reports
Cocaine
Coronary artery bypass
Coronary vessels
Drug dosages
Gynecology
Headaches
Health risk assessment
Heart surgery
Neonatology
Obstetrics
Pain
Patient compliance
Preeclampsia
Pregnancy
Pregnant women
Prostheses
Strategic planning (Business)
Thromboembolism
Thrombosis
Transplantation of organs, tissues, etc
Vascular surgery
Veins & arteries
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Summary:Background. Peripheral arterial disease (PAD) in pregnancy has serious implications and requires multidisciplinary management. This becomes even more complicated in the setting of active disease and history of prior vascular grafts. Case. A woman presented with increasing left lower extremity pain at 18 weeks of gestation with a complex history of PAD and a previous bifurcated aorta-left femoral, -right iliac bypass. CT angiogram demonstrated known occluded bypass graft. A multidisciplinary team of providers developed guidelines for potential surgical intervention based upon clinical symptoms. Conclusion. Pelvic PAD can worsen in pregnancy in the setting of the enlarging uterus, which can potentially deplete perfusion of existing collateral vessels. Symptomatic approach to worsening disease provided an effective management strategy in this case.
ISSN:2090-6684
2090-6692
DOI:10.1155/2019/2432809