Department of Internal Medicine, Radboud University Medical Center, Geert Grooteplein Zuid 8, 6525 GA Nijmegen, The Netherlands; Department of Medicine III, Carl Gustav Carus University Medical Centre, Dresden, Germany.
Institute of Clinical Chemistry and Laboratory Medicine, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetcherstrasse 74, 01307 Dresden, Germany.
Endocrinol Metab Clin North Am. 2019 Sep;48(3):605-617. doi: 10.1016/j.ecl.2019.05.006. Epub 2019 Jun 13.
Pheochromocytoma during pregnancy, although rare, is a perilous condition. The wellbeing of mother and fetus are at stake if not diagnosed and treated antenatally and timely. The diagnosis is frequently overlooked because of the aspecific nature of signs and symptoms and confusion with pregnancy-related hypertension. Measurements of plasma or urinary free metanephrines have the highest diagnostic accuracy. MRI is preferred over ultrasonography. The optimal time for surgical removal is before 24 weeks of gestation or at/after delivery. Laparoscopic adrenalectomy should be preceded by medical pretreatment. Cesarean delivery is preferred in these patients; vaginal delivery might be considered in selected pretreated patients.
妊娠期间的嗜铬细胞瘤虽然罕见，但却是一种危险的情况。如果不在产前及时诊断和治疗，母亲和胎儿的健康都会受到威胁。由于其体征和症状的非特异性，以及与妊娠相关性高血压的混淆，因此常常会被忽视诊断。测量血浆或尿液中的游离甲氧基肾上腺素具有最高的诊断准确性。磁共振成像优于超声检查。手术切除的最佳时间是在妊娠 24 周之前或分娩时/之后。腹腔镜肾上腺切除术应在药物预处理之前进行。这些患者首选剖宫产；在经过选择的预处理患者中，也可以考虑阴道分娩。
