Acute spontaneous non-hemorrhagic adrenal infarction in pregnancy: case-report and literature review.
Sara OrnaghiFederica FernicolaElisabetta MarelliMario PerottiFiliberto Di GennaroIrene CameroniEloisa M MarianiAngela I PincelliElisabetta ColciagoIrene CetinPatrizia VerganiPublished in: Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology (2023)
Unilateral non-hemorrhagic adrenal infarction (NHAI) is a very uncommon cause of acute abdomen in pregnancy. Diagnosis is highly challenging due to its rarity, heterogeneity of clinical presentation, and inconclusiveness of the initial workup. Timely recognition is pivotal to ensuring optimal outcomes. Here we describe a case of spontaneous unilateral NHAI diagnosed in a singleton pregnant woman at 32 weeks' gestation at our centre and provide the findings of an extensive literature review on the topic. We identified 22 articles describing 31 NHAI cases in 30 obstetric patients: NHAI occurs more frequently on the right side and in the third trimester, and diagnosis is formulated more than 24 h after clinical presentation in 50% of cases; second-level imaging is always necessary to reach a definitive diagnosis and start appropriate treatment. A high degree of clinical suspicion is needed to promptly recognize NHAI in pregnancy, thus allowing appropriate multidisciplinary management and timely treatment initiation. Promotion of knowledge and awareness of NHAI as a potential cause of acute abdomen in pregnancy is mandatory to improve clinical practice and, ultimately, perinatal outcomes.
Keyphrases
- preterm birth
- liver failure
- pregnancy outcomes
- gestational age
- pregnant women
- respiratory failure
- clinical practice
- drug induced
- healthcare
- end stage renal disease
- case report
- aortic dissection
- high resolution
- chronic kidney disease
- ejection fraction
- newly diagnosed
- hepatitis b virus
- metabolic syndrome
- birth weight
- type diabetes
- combination therapy
- physical activity
- quality improvement
- risk assessment
- patient reported outcomes
- weight loss
- skeletal muscle
- acute respiratory distress syndrome
- human health
- locally advanced
- weight gain
- glycemic control
- fluorescence imaging