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Pulmonary AVFs occur in approximately 15 percent of patients with Osler-Weber-Rendu disease and bleeding complications, such as hemoptysis and rarely hemothorax, are recognized. Several case reports also have associated complications of pulmonary AVFs with pregnancy. We report the case of a young woman with previously undiagnosed Osler-Weber-Rendu disease who presented in the 24th week of pregnancy with hypoxemia and a spontaneous hemothorax due to intrapleural rupture of a pulmonary AVF. She underwent successful coil spring occlusion of her AVFs, the first reported use of embolotherapy in a pregnant patient. Case Report A 27-yeai^old woman was admitted to a hospital in her 24th week of pregnancy with left-sided chest pain, dyspnea and scant hemoptysis. A chest roentgenogram revealed bilateral pleural effusions and mild interstitial edema, and arterial blood gas levels were as follows: pH, 7.50; Pco2, 23 mm Hg; and Po2, 54 mm Hg while the patient was breathing room air. She was treated for presumed congestive heart failure with diuretics and digoxin. The workup included an echocardiogram which showed severe mitral regurgitation and mild mitral stenosis. A V/Q scan was interpreted as low probability for pulmonary embolism; however, tracer activity was noted in the kidneys, suggesting a right-to-left shunt. On the fourth hospital day she developed a large left pleural effusion and was transferred to our institution.