Pregnancy complicated with adrenal adenoma causing severe obstetric outcomes: A 20-year experience at a tertiary center

Abstract

Abstract Background Adrenal adenoma during pregnancy is rare and the diagnosis is challenging owing to unspecific symdromes and restricted investigation. It’s poorly described obstetric outcomes of patients underwent surgery during pregnancy or only received medicine treatment. Objective To investigate the association between adrenal adenoma and obstetric outcomes. Methods A retrospective study was performed. The clinical characteristics, management and obstetric outcome of pregnancies diagnosed as adrenal adenoma over 20 years were reviewed from a teriary hospital. Results A total of 12 women were diagnosed as adrenal adenoma during pregnancy from to January 2000 to September 2022. Eight women had cortisol-secreting adrenal adenoma, two had over-secrete catecholamine and two primary aldosteronism. The original symptoms adrenal adenoma during pregnancy included hypertension or preeclampsia, gestational diabetes mellitus or pre-pregnancy diabetes mellitus, hypokalemia and ecchymosis. There were four women took adrenalectomy during pregnancy, while 8 women only received medicine therapy. Preterm birth occurred in all cases who received medicine, whereas 1 case suffered from preterm birth in the group underwent surgery. Among the 8 women of medicine group, there were 3 neonatal death. Conclusions Once simultaneous onset of hypertension, hyperglycemia and hypokalemia during the 1st or 2nd trimester, adrenal adenoma should be investigate by laboratory examination and imaging examination. The maternal and fetal outcome were unpredictive owing to the severity of adrenal adenoma, particular in patients only received medicine treatment. Adrenalectomy should be recommended during the pregnancy.