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- L Crawford and V Amin.
- Russells Hall Hospital, Pensnett Road, Dudley, West Midlands, UK. Electronic address: louise.crawford5@nhs.net.
- Int J Obstet Anesth. 2022 Nov 1; 52: 103600103600.
AbstractThis case report addresses the management of a pregnant woman in the peripartum period with a VIPoma. This rare and highly malignant neuroendocrine tumour secretes vasoactive intestinal peptide (VIP), a substance that may cause potentially life-threatening disruption to physiology. A 36-year-old woman presented for induction of labour with a three-year history of chronic diarrhoea, hypophosphataemia, palpitations and skin flushing. Raised VIP levels indicated presence of a VIPoma, however despite extensive investigation prior to pregnancy by neuroendocrine specialists, the tumour location remained unidentified. The patient delivered a healthy boy with the aid of forceps in theatre following an epidural top-up. Key features of management were a multidisciplinary approach, avoidance of triggers for VIP secretion, strict management of electrolytes and avoidance of severe changes in sympathetic tone during labour with epidural analgesia.Copyright © 2022 Elsevier Ltd. All rights reserved.
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