Endocrine Abstracts

Introduction: Primary aldosteronism (PA) may present in younger age and it may so complicate pregnancy if not diagnosed early. Our aim was to identify patients in whom PA was diagnosed after pregnancy and to seek for possible complications during pregnancy.

Design of methods: Retrospective analysis of patients with PA.

Results: We found nine patients with PA (age at diagnosis 31.9±5 years, hypertension duration 5.9±2.6 years) suffering from hypertension 2.6±1.6 years before pregnancy (two patients had hypertension diagnosed during pregnancy). In seven cases, pregnancy was terminated with caesarean section and two patients delivered spontaneously. Preterm delivery occurred in three cases – the earliest one in the sixth month. In six cases, diagnosis of preeclampsia was made.

Subsequent diagnosis of PA (sometimes with a long delay (12 years)) was made on the basis of significantly low potassium values (two subjects suffered even from hypokalemic paralysis) and hypertension, elevated plasma/serum aldosterone and suppressed plasma renin activity or plasma renin. Eight subjects underwent laparoscopic adrenalectomy (in all cases, diagnosis of a cortical adenoma was made) and the last subjects was classified with bilateral hyperplasia according adrenal venous sampling. Operation normalized blood pressure in six subjects and improved significantly blood pressure control in remaining two subjects. One patient became pregnant after adrenalectomy and her pregnancy went uneventful.

Conclusion: The most frequent pregnancy-related complication of PA is preeclampsia. The best prevention of these complications is only early diagnosis of PA, in these particular hypertensive cases the awareness of hypokalemia.