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Cushing's syndrome during pregnancy.

W J Mulder1, A Berghout, W M Wiersinga

  • 1Department of Medicine, University of Amsterdam.

The Netherlands Journal of Medicine
|June 1, 1990
PubMed
Summary

This study reports two cases of Cushing's syndrome in pregnancy caused by adrenal adenoma. ACTH-independent Cushing's syndrome is more common during pregnancy than previously thought, though treatment offers only marginal benefits.

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Area of Science:

  • Endocrinology
  • Reproductive Medicine
  • Oncology

Background:

  • Cushing's syndrome, characterized by excessive cortisol, poses risks during pregnancy.
  • Pregnancy can exacerbate or unmask underlying endocrine disorders.

Observation:

  • Two new cases of Cushing's syndrome in pregnant patients were identified, both linked to adrenal adenomas.
  • A review of 48 cases (including the new ones) revealed ACTH-independent Cushing's syndrome in 59% of pregnant patients.

Findings:

  • ACTH-independent Cushing's syndrome is disproportionately prevalent in pregnant individuals compared to non-pregnant populations.
  • This prevalence may be associated with milder hypercortisolism in adrenal adenoma cases.
  • Active management of Cushing's syndrome during pregnancy showed a trend towards improved outcomes, though not statistically significant.

Implications:

  • The findings suggest a need for increased awareness and screening for Cushing's syndrome, particularly ACTH-independent forms, in pregnant women.
  • Further research is warranted to understand the underlying reasons for the skewed prevalence and to optimize management strategies.
  • Early diagnosis and appropriate treatment of Cushing's syndrome in pregnancy are crucial for maternal and fetal well-being.

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