title: Cardiovascular collapse after labetalol for hypertensive crisis in an undiagnosed pheochromocytoma during cesarean section.
abstract: Pheochromocytoma is a catecholamine-producing tumor but rarely delayingly diagnosed until during pregnancy. We reported a pregnant woman who underwent emergent cesarean section because of intrauterine growth retardation, oligohydramnios, and hypertension. The existence of an undiagnosed pheochromocytoma was suspected by the unusual hemodynamic response to spinal anesthesia, abdominal compressions, and operative stimulus. Hypertensive crisis occurred during the operation and she was sent to the intensive care unit for postoperative care. In the intensive care unit, cardiovascular collapse occurred after nonselective β-adrenergic blockade. Unexpected hypertensive crisis during the perioperative period should alert clinicians to the possibility of a pheochromocytoma. For the treatment of choice, nonselective β-adrenergic blockade should not be used before the α-blockade.
authors: Department of Anesthesiology, Hsinchu Mackay Memorial Hospital, Hsinchu city, Taiwan, ROC. a4787@ms7.mmh.org.tw
authors: Chi-Hang
authors: CH
authors: Kuok
authors: Chia-Rong
authors: CR
authors: Yen
authors: Chong-Sin
authors: CS
authors: Huang
authors: Yuan-Pi
authors: YP
authors: Ko
authors: Pei-Shan
authors: PS
authors: Tsai
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000150:complications*; D000319:Adrenergic beta-Antagonists / Q000009:adverse effects*; D000328:Adult; D002585:Cesarean Section; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D007741:Labetalol / Q000009:adverse effects*; D010673:Pheochromocytoma / Q000150:complications*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000503:physiopathology*; D012769:Shock / Q000209:etiology*
chemical_list: D000319:Adrenergic beta-Antagonists; D007741:Labetalol