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Adrenal Hemorrhage: A Review.
Tucker Doiron1, Lettie A Odom2, Everett F Magann3
1OB/GYN Resident, PGY-4.
Obstetrical & Gynecological Survey
|January 6, 2023
Summary
Adrenal hemorrhage in pregnancy is rare but serious. Early recognition and prompt management are crucial for reducing maternal morbidity and mortality.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Radiology
Background:
- Adrenal hemorrhage during pregnancy is a rare but potentially life-threatening condition.
- The incidence may be slightly elevated in pregnancies complicated by preeclampsia or eclampsia.
- High mortality rates underscore the need for provider awareness and prompt diagnosis.
Approach:
- A comprehensive literature search was conducted using PubMed, CINAHL, and EMBASE (2015-2021).
- Search terms focused on adrenal hemorrhage in the context of pregnancy and maternal health.
- 30 relevant articles were selected from 130 identified abstracts for this evidence-based review.
Key Points:
- Common symptoms include abdominal, back, and flank pain.
- Diagnosis typically involves ultrasound and CT or MRI.
- Management ranges from conservative approaches to surgical intervention or embolization for unstable patients.
- Steroid replacement is indicated for adrenal insufficiency.
- Bilateral hemorrhage increases the likelihood of requiring steroid therapy.
Conclusions:
- Early recognition and management of adrenal hemorrhage in pregnancy are essential.
- Prompt diagnosis and intervention can significantly decrease associated morbidity and mortality.
- Conservative management allows many patients to continue pregnancies to term with no contraindications to vaginal delivery.
