Article

Eplerenone Use in Primary Aldosteronism During Pregnancy

Department of Internal Medicine, Nephrology, and Health SciencesHypertension UnitAzienda Ospedaliera Universitaria di ParmaParma, Italy.
Hypertension (Impact Factor: 7.63). 12/2011; 59(2):e18-9. DOI: 10.1161/HYPERTENSIONAHA.111.187237
Source: PubMed
Download full-text

Full-text

Available from: Giuseppe Regolisti, Feb 06, 2014
1 Follower
 · 
168 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Pregnancy is marked by alterations in a number of endocrine systems, including activation of the renin-angiotensin-aldosterone system and the hypothalamic-pituitary-adrenal axis. The placenta, the fetal adrenal glands and the liver constitute an interactive endocrine entity, known as the fetoplacental unit. In the fetoplacental unit, the fetal adrenal glands are the primary source of dehydroepiandrosterone sulphate, which is further metabolized by the fetal liver and placenta to produce a variety of oestrogens. Several disorders can affect both the fetal and maternal adrenal glands during pregnancy. The most common fetal adrenal disorder, steroid 21-hydroxylase deficiency, leads to abnormalities in sexual development and can be life threatening for the neonate. Although rare, maternal adrenal disorders are associated with considerable maternal mortality and morbidity if not promptly recognized and treated. However, diagnosis is often difficult to establish because of the endocrine changes occurring during normal pregnancies and the lack of reference values for the majority of the adrenal steroids. This Review provides an overview of adrenal steroid metabolism during pregnancy and focuses on diagnosis and treatment of the most common fetal and maternal adrenal disorders.
    Nature Reviews Endocrinology 09/2012; 8(11):668-78. DOI:10.1038/nrendo.2012.155 · 12.96 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: : Adrenal diseases-including disorders such as Cushing's syndrome, Addison's disease, pheochromocytoma, primary hyperaldosteronism and congenital adrenal hyperplasia-are relatively rare in pregnancy, but a timely diagnosis and proper treatment are critical because these disorders can cause maternal and fetal morbidity and mortality. Making the diagnosis of adrenal disorders in pregnancy is challenging as symptoms associated with pregnancy are also seen in adrenal diseases. In addition, pregnancy is marked by several endocrine changes, including activation of the renin-angiotensin-aldosterone system and the hypothalamic-pituitary-adrenal axis. The aim of this article was to review the pathophysiology, clinical manifestation, diagnosis and management of various adrenal disorders during pregnancy.
    The American Journal of the Medical Sciences 03/2013; 347(1). DOI:10.1097/MAJ.0b013e31828aaeee · 1.52 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Hypertensive pregnancy disorders complicate 6% to 8% of pregnancies and cause significant maternal and fetal morbidity and mortality. The goal of treatment is to prevent significant cerebrovascular and cardiovascular events in the mother without compromising fetal well-being. Current guidelines differentiate between the treatment of women with acute hypertensive syndromes of pregnancy and women with preexisting chronic hypertension in pregnancy. This review will address the management of hypertension in pregnancy, review the various pharmacologic therapies, and discuss the future directions in this field.
    Advances in Chronic Kidney Disease 05/2013; 20(3):229–239. DOI:10.1053/j.ackd.2013.01.014 · 1.94 Impact Factor