scholarly journals Late diagnosis of pheochromocytoma in pregnancy with poor fetal outcome

2021 ◽  
Vol 27 (1) ◽  
pp. 9-11 ◽  
Author(s):  
Gauri Bapayeva ◽  
Milan Terzic ◽  
Karlygash Togyzbayeva ◽  
Aigerim Bekenova ◽  
Sanja Terzic ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Gestational Hypertension ◽  
Fetal Lung ◽  
Abdominal Ultrasound ◽  
First Trimester ◽  
Maternal Blood ◽  
Fetal Outcome ◽  
Hypertensive Disorder ◽  
Emergency Cesarean ◽  
In Pregnancy

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.

Hypertension in pregnancy

2010 ◽  
pp. 2093-2102 ◽  
Author(s):  
C.W.G. Redman
Keyword(s):  
Blood Pressure ◽  
Renal Insufficiency ◽  
Arterial Pressure ◽  
Diastolic Pressure ◽  
Gestational Hypertension ◽  
Systolic Pressure ◽  
First Trimester ◽  
Normal Pregnancy ◽  
Pregnancy Induced Hypertension ◽  
In Pregnancy

In normal pregnancy the arterial pressure falls in the second half of the first trimester: systolic pressure then remains unchanged throughout pregnancy, with diastolic pressure tending to rise gradually towards its prepregnancy level in the later weeks. Definitions, epidemiology and clinical features—(1) Pregnancy-induced hypertension (PIH), transient hypertension of pregnancy, or gestational hypertension describe new hypertension, defined as blood pressure equal to or in excess of 140/90 mmHg, which without proteinuria affects up to 10% of women after mid term (20 weeks) and resolves after delivery. (2) Pre-eclampsia, which affects 3 to 5% of pregnancies, is defined by the presence of PIH and pregnancy-induced proteinuria arising after 20 weeks gestation that both improve after delivery. Other features include (a) renal insufficiency; (b) hepatocellular dysfunction and/or severe epigastric/right upper quadrant pain; (c) neurological problems—convulsions (eclampsia), severe headaches, persistent scotomata; (d) haematological disturbances—thrombocytopenia, disseminated intravascular coagulation, haemolysis; (e) fetal growth restriction....

scholarly journals Management of Hypertensive Disorders in Pregnancy- An Update

2013 ◽  
Vol 25 (1) ◽  
pp. 24-32
Author(s):  
K Nahar ◽  
TR Laila ◽  
N Akhter ◽  
PA Shamsunnahar ◽  
K Khatun ◽  
...  
Keyword(s):  
Gestational Hypertension ◽  
Expectant Management ◽  
Fetal Lung ◽  
Medical Problem ◽  
Hypertensive Disorder ◽  
Maternal Complications ◽  
Hypertensive Disorders ◽  
Hypertensive Disorders In Pregnancy ◽  
Obstetric Management ◽  
In Pregnancy

Hypertensive disorder is the most common medical problem encountered in pregnancy with a high perinatal and maternal mortality & morbidity. According to the onset of hypertension in relation to pregnancy and its duration and the development of proteinuria & convulsion it is   categorized into several types. The prognosis depends on duration and severity of hypertension and multi-system involvement. Aim of management is to achieve a gradual and sustained lowering of BP to prevent maternal complications and to allow prolongation of pregnancy for fetal benefit. For management purpose, according to recent NICE clinical guideline gestational hypertension has been classified into mild, moderate and severe hypertension. Till now there is controversy regarding the use of antihypertensives in mild to moderate hypertension. Labetalol, hydralazine & methyldopa are used as first line drugs according to severity of hypertension. Magnesium sulphate is the anticonvulsant of choice and nimodipine is the newer alternative. Obstetric management in all the types of hypertensive disorders is almost same .Expectant management can be considered for women at <34 weeks gestation only in well equipped   centers capable of caring very pre-term babies. Antenatal corticosteroid is recommended for enhancing fetal lung maturity. There is a common consensus that the hypertensive patients should be delivered at e”37 weeks as there is no benefit in continuing the pregnancy. For women with any type of hypertensive disorders, vaginal delivery should be considered unless cesarean section is required for the usual obstetric indication. DOI: http://dx.doi.org/10.3329/bjog.v25i1.13729 Bangladesh J Obstet Gynaecol, 2010; Vol. 25(1) : 24-32

scholarly journals Prevalence of thyroid disorders in pregnancy

2018 ◽  
Vol 7 (9) ◽  
pp. 3493
Author(s):  
Sangeeta Pahwa ◽  
Sabia Mangat
Keyword(s):  
Pregnant Women ◽  
Subclinical Hypothyroidism ◽  
First Trimester ◽  
Antenatal Clinic ◽  
Fetal Outcome ◽  
Overt Hypothyroidism ◽  
Thyroid Disorders ◽  
Subclinical Hyperthyroidism ◽  
Thyroid Screening ◽  
In Pregnancy

Background: Thyroid disorders are among the common endocrine problems in pregnant women. Often overlooked in pregnancy due to nonspecific symptoms and hyper-metabolic state of pregnancy. Western literature shows prevalence of hypothyroidism in pregnancy as 2.5% and hypothyroidism as 0.1-0.4%. There is paucity of data on prevalence of thyroid disorders in India pregnant population. This study was carried out to know prevalence of thyroid disorders in pregnant women in Indian population.Methods: One hundred pregnant women attending antenatal clinic in first trimester were registered. Detailed history and examination was done. Apart from routine basic and obstetrical investigations, TSH, FT3 and FT4 level estimation was done.Results: Prevalence of thyroid dysfunction was high in this study in first trimester pregnant women, with subclinical hypothyroidism in 6%, overt hypothyroidism in 2%, subclinical hyperthyroidism 2 % and overt hyperthyroidism 0%.Conclusions: Prevalence of thyroid disorders, especially subclinical hypothyroidism (6%), overt hypothyroidism (2%) and subclinical hyperthyroidism (2%) was high. To prevent adverse effects on maternal and fetal outcome, we are emphasizing the importance of routine antenatal thyroid screening.

Amniotic Fluid Index and Mean Diastolic Maternal Blood Pressure in Pregnancy-Induced Hypertensive Patients

1996 ◽  
Vol 15 (2) ◽  
pp. 219-228
Author(s):  
Herbert Valensise ◽  
Raffaele Conforti ◽  
Dario Cipriani ◽  
Donatella Dell'anna ◽  
Alessandra Petruio ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Amniotic Fluid ◽  
Maternal Blood ◽  
Amniotic Fluid Index ◽  
Hypertensive Patients ◽  
Maternal Blood Pressure ◽  
In Pregnancy

scholarly journals DASH (Dietary Approaches to Stop Hypertension) dietary pattern and maternal blood pressure in pregnancy

2020 ◽  
Vol 33 (5) ◽  
pp. 686-697 ◽  
Author(s):  
A. U. Courtney ◽  
E. C. O’Brien ◽  
R. K. Crowley ◽  
A. A. Geraghty ◽  
M. B. Brady ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Dietary Pattern ◽  
Maternal Blood ◽  
Maternal Blood Pressure ◽  
In Pregnancy

scholarly journals Polycystic ovarian syndrome and pregnancy outcome

2017 ◽  
Vol 6 (9) ◽  
pp. 3804
Author(s):  
Chaitra Shivananjaiah ◽  
Abinaya Kannan ◽  
Mridula Devi ◽  
. Jayanthi ◽  
Satish D. ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Gestational Age ◽  
Polycystic Ovarian Syndrome ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Hypertensive Disorder ◽  
Ovarian Syndrome ◽  
In Pregnancy

Background: Polycystic ovarian syndrome (PCOS) in the present generation is a very common reproductive disorder and the prevalence is on the rise. It is associated with typical features such as insulin resistance, hyperandrogenemia and obesity which has deep implications on the pregnancy outcomes as well as a long-term health of the woman.Methods: Prospective comparative study performed over 200 pregnant women in the ESIC medical college, Bangalore. 100 women diagnosed with PCOS were compared with that of 100 normal women. The method of conception in pcos was recorded. maternal outcome in the form of abortion, gestational diabetes mellitus, hypertensive disorder in pregnancy, mode of delivery, intrapartum and postpartum complication. Fetal outcome in the form preterm delivery, small-for-gestational-age (SGA) infants, large-for-gestational-age infants, apgar at 5 minute and admission to NICU.Results: Of the 100 women who were diagnosed with PCOS, 62 had spontaneous conception, 32 conceived with ovulation induction, 4 with artificial insemination and 2 needed IVF for conception. 18 women had spontaneous abortion, 58 were diagnosed with Gestational diabetes mellitus (GDM) predominantly between 24 – 28 weeks’ period of gestation, 16 women had hypertension complicating pregnancy. Fetal outcome in the form of preterm birth was noted in 14 patients, large for gestation was noted in 11 newborns, the rate of NICU admission was significantly higher in the PCOS women’s infants constituting 33%.Conclusions: The assistance needed for conception was significantly higher in women with PCOS. The complications associated with pregnancy such as spontaneous abortions, gestational diabetes, hypertensive disorder in pregnancy, preterm births, need of NICU care for the infants are much higher in women with PCOS.  Adult health education and the preconception diagnosis and appropriate management of PCOS is an important primary mode of prevention of these associated complications. 

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