Unanticipated Hypoxemia in Late Pregnancy Revealing Hereditary Hemorrhagic Telangiectasia

Hereditary hemorrhagic telangiectasia (HHT) complicates pregnancy due to pulmonary arteriovenous malformations (PAVMs), which risk rupture from hemodynamic changes. A 26-year-old woman at 32 weeks' gestation with refractory cough, dyspnea, and hypoxemia was diagnosed with HHT based on recurrent epistaxis, telangiectasias, and an ENG deletion. Chest computed tomography revealed multiple PAVMs with a shunt fraction of 26%. Caesarean section at 33 weeks ensured maternal and fetal safety. Persistent postpartum hypoxemia necessitates endovascular embolization and home oxygen therapy. This case underscores the need for early detection and multidisciplinary management of HHT during pregnancy to mitigate life-threatening complications.