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Pheochromocytoma complicating pregnancy

Pheochromocytoma occurring during pregnancy is potentially life-threatening for mother and fetus. Undiagnosed, the mortality for mother and offspring may approach 50% (1). Prepartum diagnosis and treatment markedly improves the prognosis for the mother but fetal morbidity and mortality are still high despite treatment. Delay in diagnosis by confusion with toxemia remains a problem even today. Pheochromocytoma usually can be diagnosed during pregnancy by the appropriate analysis of a 24-h urine sample for catecholamines and catecholamine metabolites, as was the case in the report by Dahia and colleagues in this issue of European Journal of Endocrinology (2). Once the diagnosis is established, treatment with adrenergic antagonists is clearly indicated. Spontaneous vaginal delivery in untreated patients is frequently disastrous for mother and infant. Provocation of a severe pressor crisis under these circumstances, with attendant placental ischemia and fetal hypoxia, are likely causes of the untoward outcome. Magnetic resonance imaging may be useful