title: Systematic review of phaeochromocytoma in pregnancy.
abstract: BACKGROUND
  Phaeochromocytoma in pregnancy is a rare and potentially dangerous situation for mother and fetus. This review aimed to assess current mortality rates and how medical and surgical management affect these.
  
  
  METHODS
  Articles in English published between 2000 and 2011 were obtained from a MEDLINE search. Eligible publications presented women diagnosed with phaeochromocytoma in the antenatal or immediate postnatal period, and reported management and outcomes.
  
  
  RESULTS
  A total of 135 reports were identified. After applying inclusion criteria, 77 pregnancies involving 78 fetuses were analysed. Fetal and maternal mortality rates were 17 per cent (13 of 78) and 8 per cent (6 of 77) respectively. Better outcomes were achieved when the diagnosis of phaeochromocytoma was made in the antenatal period than when it was made during labour or immediately postpartum (survival of both mother and fetus(es) in 48 of 56 versus 12 of 21 respectively; P = 0·012). When the diagnosis was made before 23 weeks' gestation, there was no difference in outcomes when phaeochromocytoma surgery was carried out in the second trimester, compared with when it was postponed to the third trimester or after delivery (fetal death 2 of 18 versus 2 of 8 respectively; P = 0·563).
  
  
  CONCLUSIONS
  This review, although limited by the rarity of the condition and level of available evidence, demonstrated that survival rates are improved if the diagnosis of phaeochromocytoma can be established antenatally. With diagnosis before 23 weeks' gestation, no definite advantage of proceeding with tumour removal during the second trimester could be demonstrated.
authors.affiliation: Department of Endocrine Surgery, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
authors.forename: M A
authors.initials: MA
authors.lastname: Biggar
authors.forename: T W J
authors.initials: TW
authors.lastname: Lennard
mesh_terms: D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D005260:Female; D005313:Fetal Death / Q000209:etiology; D006801:Humans; D008428:Maternal Mortality; D010673:Pheochromocytoma / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000379:methods; D055815:Young Adult
chemical_list: D000317:Adrenergic alpha-Antagonists; D000319:Adrenergic beta-Antagonists