Laparoscopic treatment of primary hyperaldosteronism in a pregnant patient.

P rimary hyperaldosteronism in pregnancy is a rarely reported clinical entity that may result in life-threatening complications both for mother and the fetus and is most often caused by an aldosterone producing aden oma (APA). The physiologic rise in aldosterone during pregnancy overlaps the levels seen in primary aldosteronism, making diagnosis difficult. Suppressed renin in the setting of hyperaldosteronism is, however, diagnostic. Accompanying hypertension and hypokalemia may become more difficult to be controlled as pregnancy progresses, and severe maternal hypertension may lead to intrauterine growth retardation, placental abruption and preterm delivery. The introduction of advanced laparoscopic techniques has improved the care and therapy for patients with APA in general. Rarely, laparoscopic adrenalectomy has also been performed for pregnant patients. To our know ledge, in this report we document the first laparoscopic retroperitoneal adrenalectomy for an APA in a pregnant patient.