Phaeochromocytoma: an unusual cause of hypertension in pregnancy
β Scribed by A. S. Bullough; S. Karadia; M. Watters
- Publisher
- John Wiley and Sons
- Year
- 2001
- Tongue
- English
- Weight
- 72 KB
- Volume
- 56
- Category
- Article
- ISSN
- 0003-2409
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β¦ Synopsis
A primiparous, fullβterm, 28βyearβold woman underwent an emergency lower segment Caesarean section under epidural anaesthesia for failure to progress in the first stage. Despite an uneventful pregnancy and delivery, she developed a hypertensive crisis in the postoperative period complicated by acute pulmonary oedema requiring ventilation for 48βh in the intensive care unit. Intravenous magnesium sulphate infusions and hydralazine boluses were used to control the blood pressure, which was associated with clonus, hyperreflexia, tachycardia and profuse sweating. The patient made a good recovery. Later measurement of urinary catecholamines in the recovery phase showed greatly elevated levels of norepinephrine, dopamine and vanillyl mandelic acid. Further investigations included a normal abdominal computed tomography scan and a Iβ123 metaβiodoβbenzylβguanidine scintigraphy scan which revealed a 3β to 4βcm irregular tumour located at the level of the lower pole of the right kidney and further liver hot spots. Intravenous magnesium sulphate infusion proved successful in controlling hypertension caused by a phaeochromocytoma in the postpartum period.
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