Phaeochromocytoma diagnosed during labour

Strachan, Andrew; Claydon, P.; Caunt, J. A.

doi:10.1093/bja/85.4.635

Cited by 27 publications

(18 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although the prognosis has improved for pregnant women during the last 30 years, pheochromocytoma remains a life‐threatening tumor for both mother and fetus. Before 1970, the diagnosis was antenatal in only 25% of the cases, and maternal and fetal mortality was 50% . Today, the diagnosis is antenatal in 83% of cases, and fetal mortality has decreased to 10% and maternal mortality to 2% .…”

Section: Discussion and Review Of Literaturementioning

confidence: 99%

Pregnancy, Cesarean, and Pheochromocytoma: A Case Report and Literature Review

Plu¹,

Sec²,

Barres³

et al. 2013

Journal of Forensic Sciences

View full text Add to dashboard Cite

A 43-year-old full-term pregnant woman (gravida 2, para 1, medical history of gestational diabetes mellitus) developed a sudden and malignant hypertension with hemoptysis, sweat, and tachycardia during a scheduled C-section. A dead newborn was delivered and was successfully resuscitated. The mother died after resistant cardiac arrest. Autopsy and pathological analyses revealed an acute pulmonary edema and a necrotic and hemorrhagic voluminous tumor of the left adrenal gland, which was a pheochromocytoma. Pheochromocytoma is a rare tumor of the adrenal glands which secretes catecholamines. In pregnant women, its symptoms can mimic gestational hypertension, preeclampsia or eclampsia, and gestational diabetes mellitus. The gestational diabetes mellitus was presumed to be a symptom of the pheochromocytoma, and cardiopulmonary failure the result from the necrosis of the tumor provoked by gravid uterus compression. From a medico-legal point of view, the tumor could not have been suspected during the pregnancy.

show abstract

Section: Discussion and Review Of Literaturementioning

confidence: 99%

Pregnancy, Cesarean, and Pheochromocytoma: A Case Report and Literature Review

Plu¹,

Sec²,

Barres³

et al. 2013

Journal of Forensic Sciences

View full text Add to dashboard Cite

show abstract

“…Recent literature describes successful and safe vaginal delivery under adequate epidural analgesia to reduce pain and stress (6,33,34,35). The period of active pushing and stress during the second stage of labor can be shortened (if necessary) or even be avoided by performing an instrumental vaginal delivery by ventouse of forcipal extraction.…”

Section: Timing and Route Of Deliverymentioning

confidence: 99%

“…In these conditions, hypertensive emergency, acute pulmonary edema, malignant arrhythmias, myocardial ischemia or infarction, aortic dissection, cardiac failure and hemodynamic collapse are well-recognized complications of pheochromocytoma, and the risk of death is high after such acute presentations unless appropriate therapy is instituted quickly (34). Few case reports have described such conditions, with varying outcomes for both mother and child (1,17,34,35,40,41,42,43).…”

Section: Perioperative Managementmentioning

confidence: 99%

ENDOCRINOLOGY IN PREGNANCY: Pheochromocytoma in pregnancy: case series and review of literature

Weerd

Noord

Loeve³

et al. 2017

European Journal of Endocrinology

View full text Add to dashboard Cite

Pheochromocytoma in pregnancy is extremely rare. Early recognition is crucial as antepartum diagnosis can largely decrease maternal and fetal mortality rates. As symptoms of pheochromocytoma are rather similar to those of other far more common causes of hypertension during pregnancy, timely diagnosis is a challenge. In pregnant patients, similar to non-pregnant patients, increased plasma and/or 24-h urine (nor)metanephrine concentrations most reliably confirm the diagnosis of pheochromocytoma. MRI and ultrasound are the only imaging modalities that can be used safely during pregnancy to localize the tumor. During pregnancy, pretreatment consists of alpha blockade as usual. However, dosing of α-adrenergic receptor blockers during pregnancy is a challenge as hypertension must be treated while preserving adequate uteroplacental circulation. When the diagnosis is made within the first 24 weeks of pregnancy, it is generally recommended to remove the tumor in the second trimester, while resection is generally postponed till after delivery when the diagnosis is made in the third trimester and medical pretreatment is sufficient. Both during and after pregnancy, laparoscopic surgery is the preferred approach for resection of the tumor. There is no consensus in literature about the preferred route and timing of delivery. Therefore, in our opinion, decisions should be made on an individual basis by an experienced and dedicated multidisciplinary team. Over the last decades, maternal and fetal prognosis has improved considerably. Further increasing awareness of this rare diagnosis and treatment of these patients by a dedicated team in a tertiary referral hospital are critical factors for optimal maternal and fetal outcome.

show abstract

“…14,15 However, the proportion might be higher in pregnant women, as seen in our series (40%, 2/5) and that reported by Oliva et al (66.7%, 4/6). 9 Strachan et al 16 proposed that the combined occurrence of sudden, severe hypertension and abnormal glucose tolerance should lead to a presumptive diagnosis of pheochromocytoma. The majority of familial cases of pheochromocytomas and approximately 10-20% of apparently sporadic cases have been found to be associated with mutations in 10 susceptibility genes.…”

mentioning

confidence: 99%

Outcomes of concurrent Caesarean delivery and pheochromocytoma resection in late pregnancy

Song

Liu

et al. 2013

Internal Medicine Journal

View full text Add to dashboard Cite

Undiagnosed pheochromocytoma in pregnancy is associated with significant maternal and foetal mortality. Herein we reviewed five cases of pheochromocytoma in pregnancy occurring during late pregnancy. The mean age at presentation was 30.6 years, and the gestational age ranged from 26 to 36 weeks. All patients had elevated levels of urinary catecholamines. In three patients, the lesion was located in the adrenal gland, in one patient the urinary bladder, and there was one case of recurrent malignant pheochromocytoma with metastases. Tumour resections were performed at the time of Caesarean section in four patients, two through laparoscopy. When pheochromocytoma is diagnosed in pregnancy after the second trimester, concurrent tumour resection with Caesarean section is feasible and in our series was achieved in four cases without adverse maternal or foetal consequences.

show abstract

Phaeochromocytoma diagnosed during labour

Abstract: The diagnosis of phaeochromocytoma during pregnancy is rare. We present the management of vaginal delivery in a woman diagnosed with the condition during labour. A Medline search and follow-up of references failed to find any similar report in the last 30 years.

Cited by 27 publications

References 4 publications

Pregnancy, Cesarean, and Pheochromocytoma: A Case Report and Literature Review

Pregnancy, Cesarean, and Pheochromocytoma: A Case Report and Literature Review

ENDOCRINOLOGY IN PREGNANCY: Pheochromocytoma in pregnancy: case series and review of literature

Outcomes of concurrent Caesarean delivery and pheochromocytoma resection in late pregnancy

Contact Info

Product

Resources

About