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Cushing's syndrome and pregnancy
D C Aron1, A M Schnall, L R Sheeler
1Department of Medicine, Case Western Reserve University, Cleveland, OH.
American Journal of Obstetrics and Gynecology
|January 1, 1990
Summary
Pregnancy is rare in women with Cushing's syndrome due to hormonal imbalances. Careful diagnosis and individualized treatment are crucial due to increased maternal and fetal risks during pregnancy.
Area of Science:
- Endocrinology
- Reproductive Medicine
Background:
- Cushing's syndrome, characterized by excess glucocorticoids, often causes menstrual irregularities, making pregnancy uncommon.
- Physiological changes during pregnancy can mimic Cushing's syndrome symptoms, complicating diagnosis.
Purpose of the Study:
- To review documented pregnancies in women with Cushing's syndrome.
- To highlight diagnostic challenges and management strategies for pregnant women with hypercortisolism.
Main Methods:
- Literature review of 63 cases of pregnancy in women with Cushing's syndrome.
- Inclusion of four additional case studies.
Main Results:
- Pregnancy is infrequent in Cushing's syndrome, with 75% of premenopausal women experiencing amenorrhea or oligomenorrhea.
- Increased maternal and fetal risks are associated with pregnancy in hypercortisolemic women.
- Diagnostic delays can occur due to overlapping symptoms between pregnancy and Cushing's syndrome.
Conclusions:
- A high index of clinical suspicion is necessary for timely diagnosis of Cushing's syndrome in pregnant women.
- Management requires an individualized approach due to the disease's variable severity.
- Addressing hypercortisolism is vital for improving maternal and fetal outcomes.