Diagnosis and Management of Primary Aldosteronism in Pregnancy: Case Report and Review of the Literature

Toshiaki Okawa; Kimisato Asano; Toshihiro Hashimoto; Keiya Fujimori; Kaoru Yanagida; Akira Sato

doi:10.1055/s-2002-20170

American Journal of Perinatology, Table of Contents

Am J Perinatol 2002; 19(1): 031-036
DOI: 10.1055/s-2002-20170

ORIGINAL ARTICLE

Diagnosis and Management of Primary Aldosteronism in Pregnancy: Case Report and Review of the Literature

Toshiaki Okawa, Kimisato Asano, Toshihiro Hashimoto, Keiya Fujimori, Kaoru Yanagida, Akira Sato

Department of Obstetrics and Gynecology, Fukushima Medical University, School of Medicine, Fukushima, Japan

Abstract

ABSTRACT

Primary aldosteronism rarely complicates pregnancy. We present a woman with primary aldosteronism in pregnancy associated with severe preeclampsia. A 33-year-old Japanese woman with hypertension was referred to our hospital at 25 weeks of gestation. Her blood pressure was 180/100 mmHg, and laboratory tests identified a low serum potassium level and moderate proteinuria on urinalysis. The fetus was diagnosed with growth restriction. Plasma renin activity (PRA) value was 2.2 ng/mL/h and plasma aldosterone concentration (PAC) was elevated (260 pg/mL). The patient was treated medically. At 27 weeks of gestation, we noted persistent late fetal heart rate decelerations associated with uterine contractions. Therefore, elective caesarean section was performed and she was delivered of a 698-g female. After delivery, PRA declined and PAC remained elevated. Abdominal computerized tomography scan and I-iodochoresterol scan revealed a tumor in the left adrenal gland. Laparoscopic adrenalectomy was performed and confirmed the clinical diagnosis.

KEYWORD

Primary aldosteronism - pregnancy - rennin

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References

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