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- Publisher
- Springer International Publishing
- Copyright
- © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022
- ISBN
- 978-3-030-84366-3
- Pages
- 325 –339
- DOI
- 10.1007/978-3-030-84367-0_36
- Publisher site
- See Chapter on Publisher Site
Abstract
[Pheochromocytoma in pregnancy is a rare condition; however, its early diagnosis significantly decreases maternal and fetal mortality. Overall, diagnosis and treatment of pheochromocytoma are similar to that in the nonpregnant patient except for certain challenges and exceptions such as the following: Some imaging studies are contraindicated in pregnancy, surgery is only recommended during the second trimester, and the laparoscopic surgical approach is limited to transperitoneal/transabdominal. Biochemical diagnosis with plasma metanephrines and/or 24-hour urinary fractionated metanephrines and catecholamines have the same reference range in pregnancy as in the general nonpregnant population. The only imaging modality considered safe in pregnancy is MRI without gadolinium, while nuclear imaging is contraindicated. Adrenergic receptor blockers can be effective in pregnancy, and the benefits of using them outweigh the risks of not doing so. In instances where pheochromocytoma is diagnosed later than the second trimester of pregnancy, surgical excision of pheochromocytoma should be considered concomitantly with C-section or postpartum. Either C-section or vaginal delivery can be considered in pregnant women with pheochromocytoma based on individualized decision-making.]
Published: Jan 4, 2022
Keywords: Pheochromocytoma; Pregnancy; Adrenalectomy; Adrenal tumor; Catecholamines; Phenoxybenzamine; Doxazosin; β-Blocker