Conn’s Syndrome Presenting as Severe Preeclampsia in a 31-Week Pregnant Woman: A Case Report and Literature Review

Hypertension is a leading cause of maternal and fetal morbidity and mortality. While preeclampsia is the most common cause, secondary etiologies, such as Primary Aldosteronism (PA), may be underdiagnosed. This study presented a 25-year-old woman at 31 weeks of gestation who presented with severe hypertension and hypokalemia. She was initially managed as a severe preeclampsia case, but her condition was refractory to triple antihypertensive therapy and potassium supplementation. Further evaluation revealed laboratory findings consistent with PA, including suppressed plasma renin activity and an elevated aldosterone-to-renin ratio. The patient subsequently developed placental abruption, necessitating an emergency Cesarean section. The neonate was delivered with intrauterine growth restriction. Postpartum imaging identified a right adrenal adenoma, and histopathology confirmed Conn's syndrome. This case highlights the importance of considering secondary hypertension in pregnancy, especially in treatment-resistant blood pressure and persistent hypokalemia. Early diagnosis and multidisciplinary management are essential for improving the outcomes.