PPGL (pheochromocytoma & paraganglioma) in pregnancy is a serious disorder leading to a high risk for the child and the mother if left undiagnosed antepartum. The study aims to understand the clinical clues of PPGL, which will allow better diagnosis.
The researchers used case reports of PPGL during pregnancy between 1988 and 2019 in French, English, Dutch, and German. The cases with minimum clinical data on PPGL in pregnancy were the primary data. Two authors worked on data extractions and quality assessment. The team calculated the odds ratio and used multi and uni-variable logistic regression analysis.
The fetal and maternal mortalities were 14.2% and 9%, respectively. The maternal mortality was 42 times higher in cases with PPGL diagnosed post-mortem than ones diagnosed antepartum. The fetus mortality was 2.6 times higher in the individuals with post-mortem diagnosis than the antepartum diagnosis. Common clinical clues for antepartum diagnosis were hypertension (odds ratio – OR – 2.29), sweating (OR-3.14), and PPGL history, adrenal mass, or PPGL-associated mutation (OR – 8.87). Acute symptom onset, diagnosis of preeclampsia, maternal tachycardia, and obstetric care admission were independent clues of post-partum diagnosis.
The study classified the independent factors for antepartum and post-partum diagnosis. These clues will assist healthcare providers to improve the diagnosis of the condition and improve the outcome.