Immediate alpha-adrenergic blockade for pheochromocytoma associated with pregnancy is likely to yield a better outcome than surgery, according to the largest cohort study yet on the topic.

The study of the rare condition drew on data for 249 pregnancies in 232 women with pheochromocytoma or paraganglioma (collectively, PPGL) discovered either before (15%) or during (54%) pregnancy or in the year postpartum (31%).

Most cases were from an international pheochromocytoma and pregnancy registry covering 25 countries, while the rest were found in a systematic literature review, the authors reported in the Lancet Endocrinology and Diabetes.

Analysing 229 completed pregnancies which had functional PPGL and were not electively terminated, maternal death or severe complications such as stroke or MI occurred in 18 women (8%) and there were 20 fetal deaths (9%) over a period including the pregnancy and the first three days postpartum.