Ruptured renal artery aneurysm in pregnancy

Renal artery aneurysm is a rare condition, the incidence being ~0.01 - 1%. In pregnancy this condition is rare but carries a significant mortality. Predisposing factors in pregnancy are thought to be physiological, hormonal and haemodynamic. Clinical diagnosis requires a high level of suspicion, as patients are usually asymptomatic prior to rupture. The clinical presentation often mimics other common obstetric conditions such as labour, uterine rupture or placental abruption. It is essential at laparotomy in cases of intra-abdominal bleeding that a thorough search is made for the source of blood loss when no obvious obstetric cause is found. We report a case of a maternal death that was due to rupture of a renal artery aneurysm in the immediate peripartum period in a patient with chronic hypertension.