{"id":"9224ff905281","type":"article","url":"https://hartvaat.nl/2022/09/01/primair-aldosteronisme-in-de-zwangerschap-systematische-review/","title":"Primair aldosteronisme in de zwangerschap: systematische review","title_en":"Management and Outcomes of Primary Aldosteronism in Pregnancy: A Systematic Review.","category":"hypertensie","category_label":"Hypertensie","professions":["huisarts","internist"],"tags":["aldosteronsynthaseremmers","baxdrostat","lorundrostat","mra-aldosteronantagonisten","resistente-hypertensie-aldosteronremmers","spironolacton"],"journal":"Hypertension (Dallas, Tex. : 1979)","doi":"10.1161/HYPERTENSIONAHA.121.18858","source_url":"https://doi.org/10.1161/HYPERTENSIONAHA.121.18858","authors":["Viola Sanga","Giacomo Rossitto","Teresa Maria Seccia","Gian Paolo Rossi"],"significance":5,"published":"2022-09-01","source_date":"2022-09-01","image":"","kennis":["https://hartvaat.nl/kennis/hypertensie/hypertensie-en-zwangerschap/","https://hartvaat.nl/kennis/hypertensie/centrale-middelen-hypertensie/"],"congress":"","summary_en":"This systematic review documented the diagnostic and therapeutic challenges of primary aldosteronism during pregnancy, providing practical guidance for managing this uncommon but serious gestational condition.","created":"2026-07-03T10:29:54Z","updated":"2026-07-03T13:29:00Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Systematische review documenteerde de diagnostische en therapeutische uitdagingen van primair aldosteronisme tijdens de zwangerschap. De aandoening is zeldzaam maar kan ernstige complicaties veroorzaken. Labetalol en alfa-methyldopa zijn veilige antihypertensiva; spironolacton is gecontra-indiceerd.","abstract_original":"Primary aldosteronism (PA) in pregnancy (PAP) can be a serious condition and is challenging to diagnose. This study was conceived to help in the diagnosis of PAP and provide suggestions on management of PAP based on evidence retrieved using a Population, Intervention, Comparison, and Outcome search strategy. Based on the changes of aldosterone and renin occurring in normal pregnancies, we developed a nomogram that will allow to identify PAP cases. Moreover, we found that published PAP cases fell into 4 main groups differing for management and outcomes: (1) unilateral medically treated, (2) unilateral surgically treated, (3) bilateral medically treated and (4) familial forms. Results showed that complications involved 62.2% of pregnant women with nonfamilial PA and 18.5% of those with familial hyperaldosteronism type I. Adrenalectomy during pregnancy in women with PAP did not improve maternal and fetal outcomes, over medical treatment alone. Moreover, cure of maternal hypertension and mother and baby outcome were better when unilateral PA was discovered and surgically treated before or after pregnancy. Therefore, fertile women with arterial hypertension should be screened for PA before pregnancy and, if necessary, subtyped to identify unilateral forms of PA. This will allow to furnish adequate counseling, a chance for surgical cure and, therefore, for a pregnancy not complicated by aldosterone excess."}