Conundrums of Diagnosis and Management of Cushing's Syndrome in Pregnancy.

Maria Fleseriu, Monica Livia Gheorghiu

Journal: Endocrinology and metabolism clinics of North America 2024;53(3):421-435

PMID: 39084817

Full Text on Elsevier Science View on PubMed

Abstract

Pregnancy is rare in women with Cushing's syndrome (CS), due to hypercortisolism-induced gonadotropin suppression and anovulation. Diagnosis of CS is hampered by physiological cortisol level increases during normal pregnancy; importantly abnormal cortisol secretion circadian rhythm could be diagnostic. Active CS is associated with considerable maternal and fetal complications. Second trimester surgery (pituitary or adrenal) is the main treatment option, however observation in mild cases has been suggested. Medical treatment, although not approved for use in pregnancy, may be considered, after careful discussion and balancing any benefits with potential risks and side-effects.

Address: Department of Clinical Endocrinology IV, Carol Davila University of Medicine and Pharmacy Bucharest, Romania; CI Parhon National Institute of Endocrinology, 34-36 Aviatorilor Boulevard, Sector 1, 011863, Bucharest, Romania.; Department of Medicine, Division of Endocrinology, Diabetes and Clinical Nutrition, Oregon Health & Science University, Portland, Oregon, USA; Department of Neurological Surgery, Oregon Health & Science University, Portland, OR, USA; Pituitary Center, Oregon Health & Science University, Portland, OR, USA. Electronic address: [email protected].

DOI: 10.1016/j.ecl.2024.05.007

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MeSH Terms: Humans, Pregnancy, Cushing Syndrome, Female, Pregnancy Complications