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Diverse presentations of Cushing's syndrome during pregnancy - A case series.
Stoinis, Natasha; Creeper, Katherine; Phillips, Jessica; Graham, Dorothy; Lim, Ee Mun.
Afiliação
  • Stoinis N; Department of Obstetric Medicine, King Edward Memorial Hospital, Perth, Western Australia, Australia.
  • Creeper K; Department of General Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
  • Phillips J; Department of Obstetric Medicine, King Edward Memorial Hospital, Perth, Western Australia, Australia.
  • Graham D; Department of Obstetric Medicine, King Edward Memorial Hospital, Perth, Western Australia, Australia.
  • Lim EM; Department of Obstetric Medicine, King Edward Memorial Hospital, Perth, Western Australia, Australia.
Aust N Z J Obstet Gynaecol ; 64(4): 314-318, 2024 Aug.
Article em En | MEDLINE | ID: mdl-38284434
ABSTRACT

BACKGROUND:

Cushing's syndrome (CS) encompasses various causes of hypercortisolism including adrenocorticotropic hormone (ACTH) secreting pituitary adenoma with or without bilateral adrenal hyperplasia, an adrenal adenoma or carcinoma, ectopic ACTH or corticotrophin-releasing hormone (CRH) secretion by a neoplasm or exogenous corticosteroid therapy. The diagnosis of CS in pregnancy presents a challenge due to overlapping clinical features of pregnancy (weight gain, striae, acne). If untreated, CS in pregnancy is associated with increased risk of maternal and fetal complications.

AIMS:

With fewer than 250 cases currently published, we aim to review the clinical presentations, diagnostic methods, management, and outcomes of patients with CS in pregnancy to help optimise our clinical practice. MATERIALS AND

METHODS:

This is a single-centre, retrospective review of woman with documented hypercortisolism receiving antenatal care at a tertiary maternity hospital in Perth between 2006 to 2022. Data were collated from electronic and chart reviews. OMNI calculator was used for birthweight calculations. Local ethics and patient consent were obtained.

RESULTS:

Five women and seven pregnancies were identified. Four women had a pituitary source of ACTH-dependent CS as confirmed by brain magnetic resonance imaging. One woman had an ectopic source of ACTH. Two women were diagnosed during pregnancy. All pregnancies occurring prior to treatment of the Cushing's disease were complicated by secondary hypertension and diabetes.

CONCLUSION:

CS represents a rare and difficult to diagnose condition in pregnancy. When untreated, maternal and fetal outcomes are compromised. Close monitoring of the associated complications with involvement of a multidisciplinary team are recommended.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Complicações na Gravidez / Síndrome de Cushing Limite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Aust N Z J Obstet Gynaecol Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Austrália

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Complicações na Gravidez / Síndrome de Cushing Limite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Aust N Z J Obstet Gynaecol Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Austrália