PDF(Pubmed)
Abstract：
BACKGROUND: Functioning adrenal adenoma during pregnancy is rare, and the diagnosis is challenging owing to unspecific symptoms and restricted investigations. The obstetric outcomes of patients who undergo surgery during pregnancy or who receive only medical treatment are poorly described.
OBJECTIVE: The aim was to investigate the associations between functioning adrenal adenomas and obstetric outcomes.
METHODS: A retrospective study was performed in a tertiary center over 20 years. The clinical characteristics, management and obstetric outcomes of the diagnosed pregnant women were reviewed.
RESULTS: A total of 12 women were diagnosed with functioning adrenal adenomas during pregnancy from January 2002 to September 2022. Eight women had cortisol-secreting adrenal adenomas, two had excessive catecholamine secretion, and two had primary aldosteronism. The initial symptoms of adrenal adenoma during pregnancy included hypertension or preeclampsia, gestational diabetes mellitus or prepregnancy diabetes mellitus, hypokalemia and ecchymosis. Four women underwent adrenalectomy during pregnancy, while 8 women received only medical therapy. Preterm birth occurred in all patients who received medicine, whereas 1 patient who underwent surgery experienced preterm birth. Among the 8 women in the medical treatment group, 3 had neonates who died.
CONCLUSIONS: Once hypertension, hyperglycemia and hypokalemia occur during the 1st or 2nd trimester, pregnant women with adrenal adenomas should be evaluated via laboratory and imaging examinations. The maternal and fetal outcomes were unpredictable owing to the severity of adrenal adenoma, particularly in patients who received only medical treatment. Adrenalectomy should be recommended during pregnancy.
OBJECTIVE: The aim was to investigate the associations between functioning adrenal adenomas and obstetric outcomes.
METHODS: A retrospective study was performed in a tertiary center over 20 years. The clinical characteristics, management and obstetric outcomes of the diagnosed pregnant women were reviewed.
RESULTS: A total of 12 women were diagnosed with functioning adrenal adenomas during pregnancy from January 2002 to September 2022. Eight women had cortisol-secreting adrenal adenomas, two had excessive catecholamine secretion, and two had primary aldosteronism. The initial symptoms of adrenal adenoma during pregnancy included hypertension or preeclampsia, gestational diabetes mellitus or prepregnancy diabetes mellitus, hypokalemia and ecchymosis. Four women underwent adrenalectomy during pregnancy, while 8 women received only medical therapy. Preterm birth occurred in all patients who received medicine, whereas 1 patient who underwent surgery experienced preterm birth. Among the 8 women in the medical treatment group, 3 had neonates who died.
CONCLUSIONS: Once hypertension, hyperglycemia and hypokalemia occur during the 1st or 2nd trimester, pregnant women with adrenal adenomas should be evaluated via laboratory and imaging examinations. The maternal and fetal outcomes were unpredictable owing to the severity of adrenal adenoma, particularly in patients who received only medical treatment. Adrenalectomy should be recommended during pregnancy.
摘要：
背景：妊娠期功能性肾上腺腺瘤很少见，由于非特异性症状和有限的检查，诊断具有挑战性。在怀孕期间接受手术或仅接受药物治疗的患者的产科结局描述不佳。
目的：目的是研究功能性肾上腺腺瘤与产科结局之间的关系。
方法：在一个三级研究中心进行了20年的回顾性研究。临床特点,对确诊孕妇的管理和产科结局进行了回顾.
结果：从2002年1月到2022年9月，共有12名妇女在怀孕期间被诊断为功能性肾上腺腺瘤。八名妇女患有分泌皮质醇的肾上腺腺瘤，两个有过量的儿茶酚胺分泌，两个人患有原发性醛固酮症。妊娠期肾上腺腺瘤的初始症状包括高血压或先兆子痫，妊娠期糖尿病或孕前糖尿病，低钾血症和瘀斑。四名妇女在怀孕期间接受了肾上腺切除术，而8名妇女只接受了药物治疗。早产发生在所有接受药物治疗的患者中，而1例接受手术的患者经历了早产。在医疗组的8名妇女中，3名新生儿死亡。
结论：一旦高血压，高血糖和低钾血症发生在妊娠早期或中期，患有肾上腺腺瘤的孕妇应通过实验室和影像学检查进行评估。由于肾上腺腺瘤的严重程度，母体和胎儿的结局是不可预测的。特别是仅接受药物治疗的患者。建议在怀孕期间进行肾上腺切除术。
目的：目的是研究功能性肾上腺腺瘤与产科结局之间的关系。
方法：在一个三级研究中心进行了20年的回顾性研究。临床特点,对确诊孕妇的管理和产科结局进行了回顾.
结果：从2002年1月到2022年9月，共有12名妇女在怀孕期间被诊断为功能性肾上腺腺瘤。八名妇女患有分泌皮质醇的肾上腺腺瘤，两个有过量的儿茶酚胺分泌，两个人患有原发性醛固酮症。妊娠期肾上腺腺瘤的初始症状包括高血压或先兆子痫，妊娠期糖尿病或孕前糖尿病，低钾血症和瘀斑。四名妇女在怀孕期间接受了肾上腺切除术，而8名妇女只接受了药物治疗。早产发生在所有接受药物治疗的患者中，而1例接受手术的患者经历了早产。在医疗组的8名妇女中，3名新生儿死亡。
结论：一旦高血压，高血糖和低钾血症发生在妊娠早期或中期，患有肾上腺腺瘤的孕妇应通过实验室和影像学检查进行评估。由于肾上腺腺瘤的严重程度，母体和胎儿的结局是不可预测的。特别是仅接受药物治疗的患者。建议在怀孕期间进行肾上腺切除术。
