PPGL (Pheochromocytoma or paraganglioma) in pregnant women might cause intense complexity and death because of excess related catecholamine. The purpose of this study was to determine factors correlated with maternal and fetal outcomes in PPGL patients while pregnant.

The analysis was done on 186 pregnant women with PPGL and a systematic review of seven studies. The final cohort included 232 patients. After the year 1980 and PPGL before or while pregnant, the pregnancy was 12 months after giving birth. The considered outcomes were maternal or fetal death and intense cardiovascular complexities of catecholamine excess in mothers.

PPGL was detected in 37 patients before pregnancy (15%), 134 during pregnancy (54%), and 78 after pregnancy (31%). 95 patients out of 144 (66%) showed positive results after being assessed for pheochromocytoma genetic predisposition. Unfavorable outcomes were correlated with unrecognized PPGL during pregnancy (odds ratio 27·0; 95% CI 3·5–3473·1), catecholamine excess at least 10× the top limit of the ordinary range (4·7; 1·8–13·8), and abdominal or pelvic tumor location (11·3; 1·5–1440·5). Pregnant women with PPGL during pregnancy who received α-adrenergic blockade therapy showed less adverse outcomes (3·6; 1·1–13·2 for no α-adrenergic blockade vs. α-adrenergic blockade), while those who had surgery did not show better outcomes (0·9; 0·3–3·9 for no surgery vs. surgery).

In conclusion, PPGL undetected or untreated was correlated with a high risk of maternal or fetal complexities. Suitable recognition and admonition for premenopausal women who are risked to have PPGL might avoid adverse pregnancy-related outcomes.

Ref: https://www.thelancet.com/journals/landia/article/PIIS2213-8587(20)30363-6/fulltext