Abstract
Aim
Cushing’s disease in pregnancy is exceptionally rare and raises a number of treatment dilemas. We describe our management of a 30 year old woman with Cushing’s disease
who was referred to our unit when she was 13 weeks pregnant.
Method
Case report and review of literature.
Result
Following extensive discussion at our pituitary multidisciplinary team meeting and taking into account the risks of hypercortisolism for the mother and fetus transphenoidal
endoscopic surgery was undertaken at 23 weeks gestation. Pathology confirmed corticotroph adenoma and postoperatively she was put on hydrocortisone. Her diabetes was
controlled with metformin and insulin and at 33 weeks she was found hypertensive and was put on labetalol and nifedipine. At 38 weeks she had emergency CS but the baby
died 36 hours later. Assessment of cortisol status a few months after delivery, showed disease remission (9.00 am serum cortisol 71 nmo/l).
Conclusion
Pregnancy in the setting of Cushing’s relates with significant adverse sequelae; optimal management remains a major challenge and depends on severity, stage of gestation,
risks-benefits for maternal/fetal outcomes.
Cushing’s disease in pregnancy is exceptionally rare and raises a number of treatment dilemas. We describe our management of a 30 year old woman with Cushing’s disease
who was referred to our unit when she was 13 weeks pregnant.
Method
Case report and review of literature.
Result
Following extensive discussion at our pituitary multidisciplinary team meeting and taking into account the risks of hypercortisolism for the mother and fetus transphenoidal
endoscopic surgery was undertaken at 23 weeks gestation. Pathology confirmed corticotroph adenoma and postoperatively she was put on hydrocortisone. Her diabetes was
controlled with metformin and insulin and at 33 weeks she was found hypertensive and was put on labetalol and nifedipine. At 38 weeks she had emergency CS but the baby
died 36 hours later. Assessment of cortisol status a few months after delivery, showed disease remission (9.00 am serum cortisol 71 nmo/l).
Conclusion
Pregnancy in the setting of Cushing’s relates with significant adverse sequelae; optimal management remains a major challenge and depends on severity, stage of gestation,
risks-benefits for maternal/fetal outcomes.
| Original language | English |
|---|---|
| Publication status | Published - Jan 2016 |
| Event | The British Skull Base Society Meeting 2016 - Birmingham, United Kingdom Duration: 28 Jan 2016 → 29 Jan 2016 |
Conference
| Conference | The British Skull Base Society Meeting 2016 |
|---|---|
| Country/Territory | United Kingdom |
| City | Birmingham |
| Period | 28/01/16 → 29/01/16 |
