SFEBES2016 Poster Presentations Adrenal and Steroids (41 abstracts)
Incidence and outcomes of hormone-secreting adrenal tumours in pregnancy: a UK 4 year prospective cohort study
Georgia Quartermaine 1 , Kimberley Lambert 2 , Kate Rees 1 , Paul Seed 1 , Mandish Dhanjal 3 , Marian Knight 4 , DR McCance 5 & Catherine Williamson 1
1King’s College London, London, UK; 2Royal Hampshire County Hospital (RHCH), Winchester, UK; 3Queen Charlotte’s and Chelsea Hospital, London, UK; 4Oxford University, Oxford, UK; 5Royal Victoria Hospital, Belfast, UK.
Objective: To examine the monitoring, management and outcomes of adrenal tumours in pregnancy.
Design: A national, prospective observational, cohort study over 4 years using the UK Obstetric Surveillance System (UKOSS).
Setting: Consultant led obstetric units.
Patients: Women with hormone-secreting adrenal tumours (pheochromocytoma, primary aldosteronism or Cushing’s syndrome) diagnosed before or during pregnancy. Nested case-control comparisons were performed using UKOSS controls with uncomplicated singleton (n=2250) pregnancy and data from the Office of National Statistics (ONS).
Main outcome measures: Incidence, management and frequency of adverse maternal and offspring outcomes of adrenal tumours in pregnancy.
Results: Fourteen pregnant women met the inclusion criteria: nine with pheochromocytoma, three with primary aldosteronism and two with Cushing’s syndrome. All of the tumours were rare with an incidence rate of <2/100,000 pregnancies. Clinical symptoms were similar to those in non-pregnant women due to the hormones released. All women had severe hypertension in pregnancy, and in those diagnosed during pregnancy there was a more marked elevation of blood pressure than in women diagnosed prior to conception. There was a significantly increased risk of adverse pregnancy outcomes in affected women, with increased rates of stillbirth, preterm labour and operative delivery.
Conclusions: Adrenal tumours are associated with significantly increased risks for pregnant women and their babies. Data on these tumours to inform practice are limited and international collaborative efforts are likely to be needed to obtain robust data to inform guidelines for clinical management.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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