title: Primary aldosteronism and pregnancy.
abstract: Primary aldosteronism is the most common cause of secondary hypertension. Less than 50 cases of pregnancy in women with primary aldosteronism have been reported, suggesting the disorder is significantly underdiagnosed in confinement. Accurate diagnosis is complicated by physiological changes in the renin-angiotensin-aldosterone axis in pregnancy, leading to a risk of false negative results on screening tests. The course of primary aldosteronism during pregnancy is highly variable, although overall it is associated with a very high risk of fetal and maternal morbidity and mortality. The optimal management of primary aldosteronism during pregnancy is unclear, with uncertainty regarding the safety of mineralocorticoid antagonists and amiloride, their relative efficacy compared with the antihypertensive medications commonly used during pregnancy, and as to whether prognosis is improved by laparoscopic adrenalectomy where an adrenal adenoma can be demonstrated.
authors.affiliation: Mater Health Services, Raymond Tce, South Brisbane, QLD 4101, Australia. Electronic address: Adam.morton@mater.org.au.
authors.forename: Adam
authors.initials: A
authors.lastname: Morton
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D000315:Adrenalectomy; D018246:Adrenocortical Adenoma / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D006973:Hypertension / Q000209:etiology; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D011379:Prognosis; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D000451:Mineralocorticoid Receptor Antagonists
keywords: Adrenalectomy; Mineralocorticoid antagonists; Plasma renin activity; Pregnancy; Primary aldosteronism