title: [Laparoscopic adrenalectomy due to primary aldosteronism during pregnancy].
abstract: Primary aldosteronism (PA) during pregnancy is an extremely rare condition that may cause life threatening complications both for the mother and the fetus. A pregnant 31-year-old woman was referred to our hospital for the management of severe pregnancy hypertension at the beginning of her pregnancy. Her plasma aldosterone concentration (PAC) was markedly elevated (337 pg/ml), plasma rennin activity was suppressed (0.4 ng/ml/hr) and magnetic resonance imaging showed a 1.5 cm left adrenal tumor. PA due to an aldosterone producing-adenoma was diagnosed. Because of progressive uncontrollable hypertension and hypokalemia, a laproscopic adrenalectomy was performed at 24 weeks of gestation. The transabdominal approach was completed without any complication, resulting in normalization of PAC, easier management of blood pressure and improvement of hypokalemia. Because of severe pregnancy hypertension, cesarean operation was performed at 30 weeks of gestation and a girl weighing 1,235 g was delivered. The literature regarding PA during pregnancy was reviewed and the optimal timing of laparoscopic adrenalectomy during pregnancy and perioperative management were discussed.
authors.affiliation: The Department of Urology, Yamaguchi University School of Medicine.
authors.forename: Koji
authors.initials: K
authors.lastname: Shiraishi
authors.affiliation: The Department of Obstetrics and Gynecology, Saiseikai Shimonoseki General Hospital.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Kikuta
authors.affiliation: The Department of Nephrology, Saiseikai Shimonoseki General Hospital.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Nitta
authors.affiliation: The Department of Urology, Yamaguchi University School of Medicine.
authors.forename: Hideyasu
authors.initials: H
authors.lastname: Matsuyama
mesh_terms: D000315:Adrenalectomy; D000328:Adult; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000601:surgery*; D046110:Hypertension, Pregnancy-Induced; D010535:Laparoscopy; D008279:Magnetic Resonance Imaging; D011247:Pregnancy