Renal angiomyolipomas (RAMLs), the most common mesenchymal neoplasm of the kidney, occur with a significant female preponderance. Most RAMLs are identified as an incidental finding on renal imaging and remain clinically silent. The quality of evidence guiding treatment approach regarding the indications for active intervention in the general population is poor. Reports of high rates of complications of RAML in pregnancy leading to recommendations for active treatment have been based upon case studies and small case series, potentially affected by reporting and publication bias. No clinical studies or large case series have examined the course of RAML during pregnancy. The literature regarding the course, complications and management of RAML in pregnancy is reviewed.
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