Phaeochromocytoma and pregnancy--an updated appraisal.

Phaeochromocytoma in pregnancy carries a considerable risk to the mother and is even more dangerous to the fetus. It should, therefore, be kept in mind as a possible cause of hypertension in pregnancy and appropriate laboratory tests undertaken. The data presented in the literature indicate that the early diagnosis of phaeochromocytoma in pregnancy decreases maternal mortality markedly and fetal mortality less significantly. Diagnostic measures to localize the tumour before delivery are limited; radiation exposure to the fetus will be minimized by the adjunctive use of ultrasound and CAT scanning. If the diagnosis is made before 20-24 weeks, the tumour should be excised without delay and pregnancy interrupted or allowed to continue, depending on circumstances. After the 24th week, the pregnancy should usually be continued under adequate adrenergic blockade until fetal maturity is achieved. Labour and vaginal delivery should generally be avoided. Caesarean section and careful removal of the tumour at the same time are recommended.