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Moore reported two cases of spontaneous hemothorax in women with pulmonary AVF s in the fifth and eighth months of pregnancy, respectively. Postulated mechanisms for deterioration include the increased blood volume which occurs in pregnancy as well as alterations in vascular tone related to changing estrogen and progesterone concentrations. Embolotherapy is the current treatment of choice for pulmonary AVFs. Silicone balloons and coil springs are used most frequently; both methods appear to be safe and effective. Our patient had a reduction in shunt fraction from 23 to 7 percent following coil spring occlusion. The dramatic improvement in oxygenation immediately following occlusion of the AVFs indicates that an anatomic shunt through the AVFs, rather than pulmonary edema, was the major factor underlying her hypoxemia. Pregnancy is a significant risk factor for complications of pulmonary AVFs. Severe cases may require definitive therapy in order to allow continuation of the pregnancy. Proper radiation shielding of the fetus is essential during performance of the diagnostic and therapeutic angiographic procedures. Our case is the first reported of a patient undergoing embolotherapy during pregnancy due to life-threatening complications of pulmonary AVFs.