Ruchi Kalra

Abstract

Introduction: Pheochromocytoma, a rare tumor arising in the adrenal medulla, It is a catecholamineproducing tumor. It’s prevalence in hypertensive patients is 0.2%, and 0.002% of pregnancies. Its clinical presentation is typically hallmarked by sustained or intermittent hypertension associated with paroxysmal symptoms. Pheochromocytoma should also be considered if a patient has labile hypertension, hypertension resistant to treat by antihypertensive therapy, or paroxysmal symptoms (“spells”). Correct diagnosis is essential as surgical resection of the tumor dramatically reverses the clinical symptoms and may cure the hypertension. Pheochromocytoma with clinical presentation was earliest reported in 1926 when Cesar Roux in Switzerland and Charles H. Mayoin the United States successfully removed pheochromocytomas to cure the catecholamine-associated symptom complex. During pregnancy the clinical presentations can be easily confused with severe pre-eclampsia. The presentation of uncontrolled hypertension and headache not responding to medication may be misleading diagnose. It can be even more challenging if phechromocytoma is undiagnosed. This adrenal tumor also increases the risk of adverse pregnancy outcome like abortion, still birth or pre term delivery. We report this case from People’s College of Medical Science & Research Centre a case of Pheochromocytoma with Pregnancy. Keywords: Pheochromocytoma, prevalence in hypertensive.

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Abstract

Introduction: Pregnancy is the most beautiful and memorable time in a woman’s life. During pregnancy and even after the birth of a child, women are at an increased risk of experiencing psychological problems. Aim: Screening of antenatal women for risk of psychological illness and following them postnatal period for risk of Post Partum Depression. Materials and Methods: The study has cohort design.150 Antenatal women were screened during their antenatal visit between 24 weeks up till 36weeks of pregnancy by semi structured questionnaire to screen high risk women. These women were followed during Post Natal period between 4-8thday and then 4-8 weeks of postnatal period by Edinburgh Post Natal Depression Scale (EDPS) for assessment of Postnatal Depression. Result: 31% ANC women were screened as high risk 20% had high EDPS scores at 4-8 days and 8.6% at 4-8weeks. By logistic regression antenatal risk factors were statistically analyzed .1) Higher education level there is lesser risk 2) residence from rural area had 3.9 times higher risk. 3) who had supportive mother had 1.3 times lesser risk 4) supportive partner reduced risk by 4.4 times. 5) supportive family reduced risk by1.7 times 6) Previous history of depression of more than 2wks had 5.4 times higher risk 7) history of mental health problem in past had 1.5 times higher risk 8) Antenatal women having psychological illness has 4.29 times higher risk of delivering a neonate with birth weight Conclusion: Focus also on ante partum psychological risks. It is suggested to integrate mental health to maternal health care services and train health care givers for screening. Keywords: Antenatal risk of psychological illness, Post partum depression, Risk factors for antenatal psychological illness, Risk of post partum depression, Edinburgh post natal, Depression scale.

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