• Clin Med (Lond) · Jan 2025

    Review

    Bilateral Adrenal Infarction and Secondary Haemorrhage in Pregnancy: Implications of Factor V Leiden Heterozygosity: A Review of the Literature and a Case Report.

    • Wiaam Elradi, Samreen Innayat, Ahmed Hanafy, Sharifah Naseem, Abuzar Awadelkareem, and Deepika Meneni.
    • Obstetrics and Gynaecology Department, The James Cook University Hospital, South Tees NHS Foundation Trust, Middlesbrough, United Kingdom. Electronic address: wiaam.elradi@nhs.net.
    • Clin Med (Lond). 2025 Jan 24; 25 (2): 100288100288.

    AbstractAdrenal haemorrhage in pregnancy is rare but can lead to significant maternal and fetal morbidity if unrecognised. We present the case of a 25-year-old woman in her second pregnancy, who was admitted at 34 + 4 weeks of gestation with severe abdominal pain. Despite initial unremarkable assessments, further imaging revealed a left adrenal haemorrhage, with evidence of prior right adrenal infarction, resulting in primary adrenal insufficiency. Haematological investigations later confirmed heterozygous factor V Leiden as a likely contributing factor. This report underscores the diagnostic challenges of adrenal pathology in pregnancy, where symptoms may overlap with more common conditions. Immediate management with hydrocortisone therapy, supported by a multidisciplinary team (MDT), was employed, with a successful outcome for both mother and child following delivery by caesarean section.Crown Copyright © 2025. Published by Elsevier Ltd. All rights reserved.

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