Impact of maternal pheochromocytoma on the fetus and neonate

Iijima, Shigeo

doi:10.1080/09513590.2018.1540568

Cited by 8 publications

(5 citation statements)

References 57 publications

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“…Other causes of gestational hypertension may provoke the same alterations [ 9 , 22 ], which can explain the observed correlation between maternal hypertension and low APGAR scores. Deteriorations in placental circulation also increase the risk of newborns being small for gestational age, and this has in fact been described in previous reports on Pc during pregnancy [ 34 ]. We saw no such tendencies in this study.…”

Section: Discussionmentioning

confidence: 68%

Maternal pheochromocytoma and childbirth in Sweden 1973–2015: a population-based study on short and long-term outcome

Gunnesson,

Ragnarsson,

Nilsson

et al. 2024

Endocrine

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Purpose Data guiding management of pheochromocytoma and paraganglioma (PPGL) in pregnant women is limited, and long-term effects on the child are unknown. The aim of this retrospective registry-based case-cohort study was to assess how maternal PPGL and treatment impacts maternal and fetal outcome, including long-term outcome for the child. The main outcomes were maternal and fetal mortality and morbidity at delivery and relative healthcare consumption in children born by mothers with PPGL during pregnancy. Methods The National Birth Register identified 4,390,869 pregnancies between 1973–2015. Data was crosslinked with three Swedish national registers to identify women diagnosed with pheochromocytoma or paraganglioma within one year before or after childbirth. Hospital records were reviewed and register data was collected for five age-matched controls for each child until age 18. Results 21 women and 23 children were identified (incidence 4.8/1.000.000 births/year), all women with adrenal pheochromocytomas (Pc). The majority (71%) were diagnosed post-partum. Nine women (43%) were hypertensive during pregnancy. Preterm delivery was more common in Pc patients compared to controls (30% vs 6%, p < 0.001). There was no maternal or fetal mortality. Timing of tumor removal did not affect gestational weight or APGAR scores. There was no observed difference in hospital admissions between children affected by maternal Pc and controls. Conclusion Pc was commonly diagnosed after delivery and raised the risk of pre-term delivery, suggesting a need for an increased awareness of this diagnosis. However, reassuringly, there was no fetal or maternal mortality or any observed long-term impact on the children.

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Section: Discussionmentioning

confidence: 68%

Maternal pheochromocytoma and childbirth in Sweden 1973–2015: a population-based study on short and long-term outcome

Gunnesson,

Ragnarsson,

Nilsson

et al. 2024

Endocrine

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“…67 A combined measurement of fractionated metanephrines and catecholamines in a 24-hour urine collection has a sensitivity and specificity of 98%. 75 Plasma free metanephrines has a high sensitivity of almost 100%, but a specificity of 85%. 75 It is critical that all women are given written instructions on how to collect, store and deliver the 24-hour urine sample.…”

Section: Diagnosismentioning

confidence: 99%

“…75 Plasma free metanephrines has a high sensitivity of almost 100%, but a specificity of 85%. 75 It is critical that all women are given written instructions on how to collect, store and deliver the 24-hour urine sample. Furthermore, the following medications can cause a false positive result and should be stopped: tricyclic antidepressants, resperine, phenoxybenzamines, clonidine, levodopa, amphetamines, ethanol, most antipsychotics, decongestants and prochlorperazine.…”

Section: Diagnosismentioning

confidence: 99%

“…Hence, a well-timed and planned delivery by caesarean section has been the preferred method of delivery because of the associated increased stress. Besides, agents like syntocinon 75 can cause adverse haemodynamic effects, such as hypotension and tachycardia. Nonetheless, vaginal delivery combined with epidural analgesia has been successful.…”

Section: Mode Of Deliverymentioning

confidence: 99%

“…Nonetheless, vaginal delivery combined with epidural analgesia has been successful. 75 The attending physician should be prepared to manage any hypertensive crises that can occur during labour. The three agents of choice are intravenous nitroprusside, phentolamine or nicardipine.…”

Section: Mode Of Deliverymentioning

confidence: 99%

See 2 more Smart Citations

Adrenal disease and pregnancy: an overview

Ahmed

Bashir

Okunoye

et al. 2021

The Obstetric & Gynaecologis

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Although uncommon, adrenal disorders in pregnancy are associated with severe complications, especially if undiagnosed or poorly managed. Some women are on long-term steroids (especially those known to suffer from adrenal insufficiency) that suppress endogenous adrenal function. Under stress, these can become insufficientparticularly around labour and the puerperium. Adrenal insufficiency, for example, has been associated with maternal and fetal morbidity and mortality if untreated, while phaeochromocytoma is associated with considerable maternal mortality. Clinical features, diagnosis and management of the disorders of the adrenals in pregnancy are discussed, including Cushing's syndrome, adrenal insufficiency, phaeochromocytoma and paragangliomas, primary aldosteronism and congenital adrenal hyperplasia. Learning objectivesTo understand the physiological changes in the adrenal system during pregnancy. To understand the clinical features of common adrenal problems in pregnancy and how they can be diagnosed and managed to minimise complications, especially acute adrenal insufficiency. To understand how the management of adrenal disorders is altered in pregnancy and the effect of adrenal diseases on pregnancy. Ethical issuesIs there a role for in utero therapy if a prenatal diagnosis is made? Does treatment of the mother affect the fetus? Is optimal treatment of the mother limited by concerns for the fetus?

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Pheochromocytoma in Pregnancy

Vodopivec

Vaidya

2022

A Case-Based Guide to Clinical Endocrinology

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Impact of maternal pheochromocytoma on the fetus and neonate

Cited by 8 publications

References 57 publications

Maternal pheochromocytoma and childbirth in Sweden 1973–2015: a population-based study on short and long-term outcome

Maternal pheochromocytoma and childbirth in Sweden 1973–2015: a population-based study on short and long-term outcome

Adrenal disease and pregnancy: an overview

Pheochromocytoma in Pregnancy

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