title: Primary aldosteronism and pregnancy.
abstract: Hypertension (HT) is a complication of 8% of all pregnancies and 10% of HT cases are due to primary aldosteronism (PA). There is very little data on PA and pregnancy. Given the changes in the renin angiotensin system during pregnancy, the diagnosis of PA is difficult to establish during gestation. It may be suspected in hypertensive patients with hypokalemia. A comprehensive literature review identified reports covering 40 pregnancies in patients suffering from PA. Analysis of these cases shows them to be high-risk pregnancies leading to maternal and fetal complications. Pregnancy must be programmed, and if the patient has a unilateral form of PA, adrenalectomy should be performed prior to conception. It is customary to stop spironolactone prior to conception and introduce antihypertensive drugs that present no risk of teratogenicity. When conventional antihypertensive drugs used during pregnancy fail to control high blood pressure, diuretics, including potassium-sparing diuretics may be prescribed. Adrenalectomy can be considered during the second trimester of pregnancy exclusively in cases of refractory hypertension. A European retrospective study is currently underway to collect a larger number of cases.
authors.affiliation: Université Paris-Descartes Faculty of Medicine, 75006 Paris, France.
authors.forename: Ester
authors.initials: E
authors.lastname: Landau
authors.affiliation: Hypertension Unit, Assistance Publique-Hôpitaux de Paris, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France. Electronic address: laurence.amar@aphp.fr.
authors.forename: Laurence
authors.initials: L
authors.lastname: Amar
mesh_terms: D000315:Adrenalectomy; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000601:surgery; D011295:Prenatal Care / Q000379:methods
chemical_list: D000959:Antihypertensive Agents
keywords: Grossesse; Hyperaldostéronisme primaire; Pregnancy; Primary aldosteronism preeclampsia; Préclampsie; Spironolactone