Late diagnosis of pheochromocytoma in pregnancy with poor fetal outcome

  • Gauri Bapayeva Department of Obstetrics and Gynecology, National Research Center of Mother and Child Health, University Medical Center, Astana, Kazakhstan. Department of Medicine, Nazarbayev University, School of Medicine, Astana, Kazakhstan.
  • Milan Terzic Department of Obstetrics and Gynecology, National Research Center of Mother and Child Health, University Medical Center, Astana, Kazakhstan. Department of Medicine, Nazarbayev University, School of Medicine, Astana, Kazakhstan. Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania, USA.
  • Karlygash Togyzbayeva Department of Obstetrics and Gynecology, National Research Center of Mother and Child Health, University Medical Center, Astana, Kazakhstan
  • Aigerim Bekenova Department of Medicine, Nazarbayev University, School of Medicine, Astana, Kazakhstan.
  • Sanja Terzic Department of Medicine, Nazarbayev University, School of Medicine, Astana, Kazakhstan
  • Simone Garzon Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy
  • Giovanni Falzone Obstetrics and Gynaecology Unit, “Umberto I” Hospital, Enna, Italy
  • Botagoz Aitbayeva Department of Obstetrics and Gynecology, National Research Center of Mother and Child Health, University Medical Center, Astana, Kazakhstan
Keywords: Pheochromocytoma, Pregnancy, Hypertension, intrauterine growth restriction, Maternal-fetal outcome

Abstract


Pheochromocytomas are rare tumors producing catecholamines that could be a cause of secondary hypertension. On that basis, pheochromocytoma can occur as an extremely rare cause of hypertension in pregnancy and if diagnosed late can lead to adverse maternal-fetal outcome. In this case report we describe a case of pheochromocytoma affected pregnancy with poor fetal outcome. A 27-year-old pregnant woman was admitted for severe pre-eclampsia due to pre-gestational hypertension that was diagnosed during the first trimester. Due to high and uncontrolled maternal blood pressure and the worsened maternal-fetal condition after the admission induction of fetal lung maturity and emergency cesarean section were performed, but with poor fetal outcome. Later, an adrenal gland mass was identified using abdominal ultrasound and confirmed by computed tomography. After surgical adrenalectomy blood pressure of the patient was normalized. Pheochromocytoma should be considered as a possible cause of hypertensive disorder during pregnancy, particularly in cases of severe and unresponsive hypertension in order to provide for timely and appropriate treatment.

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Published
2020/08/12
Section
Short Report