Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
Rev Endocr Metab Disord. 2023 Feb;24(1):107-120. doi: 10.1007/s11154-022-09744-7. Epub 2022 Jul 1.
While most adrenal tumors are identified incidentally and are non-functional, hormone-secreting tumors can cause morbidity and mortality. Hemodynamic lability and hypertension in pregnancy are associated with worse maternal and fetal outcomes. Achieving a diagnosis of hormone excess due to adrenal tumors can be clinically more difficult in the gravid patient due to normal physiologic alterations in hormones and symptoms related to pregnancy. This review focuses on some nuances of the diagnostic work-up, perioperative care, and surgical management of adrenally-mediated cortisol excess, primary aldosteronism, and pheochromocytoma and paraganglioma in the pregnant patient.
虽然大多数肾上腺肿瘤是偶然发现的且无功能,但激素分泌性肿瘤可导致发病率和死亡率增加。妊娠期血流动力学不稳定和高血压与母婴结局较差相关。由于妊娠相关激素和症状的正常生理变化,妊娠患者由于肾上腺肿瘤导致的激素过多的诊断可能在临床上更具挑战性。本文重点介绍了妊娠患者中与皮质醇过多、原发性醛固酮增多症和嗜铬细胞瘤及副神经节瘤相关的诊断评估、围手术期护理和手术治疗的一些细微差别。