Phaeochromocytoma in Pregnancy: Still a Cause of Maternal Death

Abstract

A 31 year old primigravida had an uneventful pregnancy until the 30th week when she became severely hypertensive. She was immediately admitted with a diagnosis of severe pregnancy-induced hypertension although proteinuria was slight and a clotting screen normal. She was initially treated with hydralazine, to which labetalol was added 90 min later. Her condition continued to deteriorate and she developed tachycardia unresponsive to digoxin, pulmonary oedema and renal failure unresponsive to frusemide. Disopyramide did not normalise the cardiac arrhythmias and she suffered a fatal cardiac arrest 7 hours after admission. A large phaeochromocytoma was identified at post mortem examination. The epidemiology, clinical features, diagnosis, medical management, method of delivery and medical follow up are discussed.