Spontaneous rupture of renal angiomyolipoma during pregnancy: A report of two cases and literature review

Spontaneous rupture of renal angiomyolipoma (AML) during pregnancy is a rare but life-threatening condition. In the present study, we report two of our cases and provide a literature review of 23 case reports. We retrospectively reviewed two pregnant women who presented with spontaneous ruptured AML; both failed conservative management. In our first case, a 36-year-old woman at 9 weeks' gestation had selective renal arterial embolization with pelvic shield performed successfully. The pregnancy was continued to term, and the baby was delivered by elective Caesarean section. In our second case, a 33-year-old woman, pregnant with twins, at 32 weeks' gestation had emergency Caesarean section performed uneventfully. On-table selective renal arterial embolization was performed immediately afterwards, and the patient stabilized afterwards. Taken together with the 23 case reports in the literature, we conclude that embolization is a safe option of active intervention for ruptured AML in pregnancy when conservative management fails. It has the advantages of being minimally invasive and nephron-sparing. The risk of radiation to the foetus is acceptable if proper measures are taken to minimize foetal radiation exposure.