This is a case of acute peri-partum hypertension secondary to Conn's syndrome. The timing of presentation offers a rare insight into the hormonal physiology of pregnancy and its impact on blood pressure regulation. This case highlights the challenges of diagnosing primary hyperaldosteronism in the peripartum period and the high index of suspicion required by the obstetric physician.
EscherG. Hyperaldosteronism in pregnancy.Ther Adv Cardiovasc Dis2009; 3: 123–132
2.
MatsumotoJ, MiyakeH, IsozakiT, KoshinoT, ArakiT. Primary aldosteronism in pregnancy.J Nippon Med Sch2000; 67: 275–279
3.
MurakamiT, OguraEW, TanakaY, YamamotoM. High blood pressure lowered by pregnancy.The Lancet2000; 356: 1980
4.
ShalhovAL, LandmanJ, AfaneJ, LeviR, ClaymanRV. Laparoscopic adrenalectomy for primary hyperaldosteronism during pregnancy.J Laparoendosc Adv Surg Tech A2000; 10: 169–71
5.
NezuM, MiuraY, NoshiroT, InoueM. Primary aldosteronism as a cause of severe postpartum hypertension in two women.Am J Obstet Gynecol2000; 182: 745–6
6.
OkawaT, AsanoK, HasimotoT. Diagnosis and management of primary aldosteronism in pregnancy: case report and review of the literature.Am J Perinatol2002; 19: 31–6
7.
KosakaK, OnodaN, IshikawaT. Laparoscopic adrenalectomy on a patient with primary hyperaldosteronism during pregnancy2006; 53: 61–466
8.
NursalTZ, CaliskanK, ErtorerE, ParlakgumusA, MorayG. Laparoscopic treatment of primary hyperaldosteronism in a pregnant patient.Can J Surg2009; 52: 188–190
9.
ShigematsuK, NishidaN, SakaiH. Primary aldosteronism with aldosterone-producing adenoma consisting of pure zona glomerulosa-type cells in pregnant women.Endoc Pathol2009; 20: 66–72
10.
BiglieriEG, SlatonPE. Pregnancy and primary hyperaldosteronism.J Clin Endocrinol1967; 27: 1628–1632
WilsonM, MargantiAA, ZervoudakisJ. Blood pressure, the renin-aldosterone system and sex steroids throughout normal pregnancy.Am J Med1980; 68: 97–104
13.
HorrobinDF, MankuMS, BurstynPG. Saluretic action of aldosterone in the presence of excess cortisol: restoration of salt-retaining action by prolactin.J Endocrinol1973; 56: 343–344
14.
MankuMS, NassarBA, HorrobinDF. Effects of prolactin on the responses of rat aortic and arteriolar smooth muscle to noradrenaline and angiotensin.Lancet1973; 2: 991–994
BengalorkarGM, SaralaN, VenkatrathnammaPN, KumarTN. Effect of heparin and low-molecular weight heparin on serum potassium and sodium levels.J Pharmacol Pharmacother2011; 2: 266–269
17.
FunderJW, CareyRM, Fardella. Case detection, diagnosis, and treatment of patients with primary hyperaldosteronism: an Endocrine Society Clinical Practice Guideline.J Clin Endocrinol Metab2008; 93: 3266–3281
