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Phaeochromocytoma: an unusual cause of hypertension in pregnancy
Author(s) -
Bullough A. S.,
Karadia S.,
Watters M.
Publication year - 2001
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1046/j.1365-2044.2001.01726.x
Subject(s) - medicine , anesthesia , intensive care unit , pregnancy , hyperreflexia , blood pressure , tachycardia , hypokalemia , surgery , genetics , biology
A primiparous, full‐term, 28‐year‐old 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 48 h 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 I‐123 meta‐iodo‐benzyl‐guanidine scintigraphy scan which revealed a 3‐ to 4‐cm 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.