Cushing's Disease and Pregnancy

Polli, N; Giraldi, Francesca Pecori; Cavagnini, Francesco

doi:10.1007/s11102-005-1479-4

Cited by 19 publications

(7 citation statements)

References 49 publications

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“…Patients with preexisting Cushing's syndrome may experience exacerbations of hypercortisolism during pregnancy due to stimulation of LH/ßHCG receptors in the adrenal gland by the ßHCG produced by the placenta [74]. CIP is most commonly due to an adrenal tumor; pituitary ACTHsecreting tumors are the etiology in only 40 % of cases [74,75]. Severe maternal morbidity from CIP can occur with preeclampsia, eclampsia, pulmonary embolism, and congestive heart failure.…”

Section: Cushing's Syndrome In Pregnancymentioning

confidence: 99%

“…Fetal outcomes are also compromised in CIP, with an elevated rate of prematurity but also adrenal insufficiency and virilization. CIP may also be fatal to the mother or the fetus [74].…”

Section: Cushing's Syndrome In Pregnancymentioning

confidence: 99%

“…Although normal pregnancy is associated with increases in urinary free cortisol, levels in pregnant patients with Cushing's are usually significantly higher than the physiologic 100-300 μg/24 h increase found in normal pregnancy [77,74,78]. The loss of circadian fluctuation in serum cortisol, however, is pathognomonic of CIP [77].…”

Section: Cushing's Syndrome In Pregnancymentioning

confidence: 99%

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Secondary Hypertension in Pregnancy

2015

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Hypertension is a common medical complication of pregnancy. Although 75-80 % of women with preexisting essential hypertension will have uncomplicated pregnancies, the presence of secondary forms of hypertension adds considerably to both maternal and fetal morbidity and mortality. Renovascular hypertension, pheochromocytoma, and Cushing's syndrome in particular are associated with accelerating hypertension, superimposed preeclampsia, preterm delivery, and fetal loss. Primary aldosteronism is a more heterogeneous disorder; there are well-documented cases where blood pressure and hypokalemia are improved during pregnancy due to elevated levels of progesterone. However, superimposed preeclampsia, worsening hypertension, and early delivery are also reported. When possible, secondary forms of hypertension should be diagnosed and treated prior to conception in order to avoid these complications.

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Section: Cushing's Syndrome In Pregnancymentioning

confidence: 99%

“…Fetal outcomes are also compromised in CIP, with an elevated rate of prematurity but also adrenal insufficiency and virilization. CIP may also be fatal to the mother or the fetus [74].…”

Section: Cushing's Syndrome In Pregnancymentioning

confidence: 99%

Section: Cushing's Syndrome In Pregnancymentioning

confidence: 99%

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Secondary Hypertension in Pregnancy

2015

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“…Plasma ACTH levels can be used for differential diagnosis of ACTH-and nonACTH-dependent CS, taking into account the predominance of adrenal etiology and the physiological increase of ACTH during gestation (85). ACTH levels may not be suppressed in pregnant patients with adrenal CS, unlike in nonpregnant ones.…”

Section: Cushing's Disease and Pregnancymentioning

confidence: 99%

“…Adrenal computerized tomography (CT) scans should be avoided, and pituitary MRI should be reserved for patients for whom pituitary surgery is planned (85).…”

Section: Cushing's Disease and Pregnancymentioning

confidence: 99%

Pregnancy and pituitary disorders

Karaca¹,

Tanrıverdi²,

Ünlühızarcı³

et al. 2010

European Journal of Endocrinology

164

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Major hormonal changes emerge during pregnancy. The pituitary gland is one of the most affected organs with altered anatomy and physiology. The pituitary gland is enlarged as a result of lactotroph hyperplasia. Due to physiological changes in the pituitary and target hormone levels, binding globulins, and placental hormones, hormonal evaluation becomes more complex in pregnant women. As a consequence of physiological hormonal changes, the evaluation of pituitary functions in pregnant women is quite different from that done in the prepregnant state. Pituitary adenomas may cause problems by their hormone secretion that affects the mother and the fetus besides causing an increased risk of tumor growth. Furthermore, diagnosis, course, and treatment of pituitary diseases point out differences. The changes in anatomy and physiology of the pituitary gland during pregnancy are reviewed. Pituitary disorders namely Cushing's disease; acromegaly; prolactinoma; TSH-secreting, gonadotropin-producing, and clinically nonfunctioning adenomas; craniopharyngioma; and Sheehan's syndrome, which is one of the most common causes of hypopituitarism, lymphocytic hypophysitis, and hypopituitarism, in relation to pregnancy are discussed. Being aware of all this information will prevent any serious problems which mother and child will be exposed to.

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