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J Forensic Sci. 2013 Jul;58(4):1075-9. doi: 10.1111/1556-4029.12107. Epub 2013 Mar 25.

Pregnancy, cesarean, and pheochromocytoma: a case report and literature review.

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  • 1Institut medico-légal, 2 place Mazas, 75012, Paris, France. depluzenplus@wanadoo.fr

Abstract

A 43-year-old full-term pregnant woman (gravida 2, para 1, medical history of gestational diabetes mellitus) developed a sudden and malignant hypertension with hemoptysis, sweat, and tachycardia during a scheduled C-section. A dead newborn was delivered and was successfully resuscitated. The mother died after resistant cardiac arrest. Autopsy and pathological analyses revealed an acute pulmonary edema and a necrotic and hemorrhagic voluminous tumor of the left adrenal gland, which was a pheochromocytoma. Pheochromocytoma is a rare tumor of the adrenal glands which secretes catecholamines. In pregnant women, its symptoms can mimic gestational hypertension, preeclampsia or eclampsia, and gestational diabetes mellitus. The gestational diabetes mellitus was presumed to be a symptom of the pheochromocytoma, and cardiopulmonary failure the result from the necrosis of the tumor provoked by gravid uterus compression. From a medico-legal point of view, the tumor could not have been suspected during the pregnancy.

© 2013 American Academy of Forensic Sciences.

KEYWORDS:

Cesarean section; autopsy; forensic sciences; maternal death; pheochromocytoma; pregnancy

PMID:
23527821
[PubMed - indexed for MEDLINE]
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