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Pregnancy in Patients with Cushing's Syndrome
Marcio Carlos Machado1, Maria Candida Barisson Vilares Fragoso2, Marcello Delano Bronstein2
1Neuroendocrine Unit, Division of Endocrinology and Metabolism, Hospital das Clínicas, University of São Paulo Medical School, Avenida Enéas de Carvalho Aguiar, n° 155, 8° andar, bloco 03, São Paulo, São Paulo 05403-000, Brazil; Endocrinology Service, AC Camargo Cancer Center, Rua Prof. Antonio Prudente n° 211, São Paulo, SP 01509-010, Brazil; Laboratory for Endocrinology Cellular and Molecular - LIM25, University of São Paulo Medical School, Av. Dr. Arnaldo, 455, 4° andar, São Paulo, SP 01246-903, Brazil.
Abstract:
Progress in diagnosis and treatment of endocrine diseases has made pregnancy possible for women with endocrinopathies, including Cushing's syndrome (CS). The risk of maternal-fetal complications in patients who are not biochemically controlled, however, is substantial. Therefore, the surgical and/or medical control of hypercortisolism is mandatory prior to conceiving. A diagnosis of de novo CS during gestation is difficult due to changes in the hypothalamic-pituitary-adrenal axis during pregnancy, which may lead to some clinical features suggestive of CS along with abnormal laboratory tests. This review presents the diagnosis and management of CS during pregnancy.