PT  - JOURNAL ARTICLE
AU  - Anagnostopoulos A
AU  - Sharma S
TI  - Spontaneous adrenal haemorrhage in pregnancy
AID  - 10.1136/bcr.07.2011.4496
DP  - 2011 Sep 15
TA  - BMJ Case Reports
PG  - bcr0720114496
VI  - 2011
4099  - http://casereports.bmj.com/content/2011/bcr.07.2011.4496.short
4100  - http://casereports.bmj.com/content/2011/bcr.07.2011.4496.full
AB  - The authors present a case of spontaneous adrenal haemorrhage, in a 28-year-old woman at 36 weeks of a twin pregnancy. Initial symptom was sudden onset chest pain which soon migrated to abdomen, accompanied by hypovolaemic shock and fetal bradycardia. Subsequent caesarean section for suspected placental abruption and resuscitation with nine units of blood, 10 of cryoprecipitate, four of fresh frozen plasma and two of platelets, in order to treat anaemia of Hgb of 3.6 g/dl and disseminated intravascular coagulation, failed to stabilise the woman. A CT scan of abdomen and pelvis then revealed a 15×17×17 cm retroperitoneal haematoma, secondary to right adrenal haemorrhage. Management was with laparotomy drainage and packing of the retroperitoneal haematoma along with the use of activated factor VII. Adrenal haemorrhage in pregnancy is an extremely rare, acute, life-threatening condition, presenting with non-specific symptoms.