Pregnancy in Patients with Cushing's Syndrome

Marcio Carlos Machado; Maria Candida Barisson Vilares Fragoso; Marcello Delano Bronstein

doi:10.1016/j.ecl.2018.02.004

Pregnancy in Patients with Cushing's Syndrome

Endocrinol Metab Clin North Am. 2018 Jun;47(2):441-449. doi: 10.1016/j.ecl.2018.02.004.

Authors

Marcio Carlos Machado¹, Maria Candida Barisson Vilares Fragoso², Marcello Delano Bronstein³

Affiliations

¹ Neuroendocrine Unit, Division of Endocrinology and Metabolism, Hospital das Clínicas, University of São Paulo Medical School, Avenida Enéas de Carvalho Aguiar, n° 155, 8° andar, bloco 03, São Paulo, São Paulo 05403-000, Brazil; Endocrinology Service, AC Camargo Cancer Center, Rua Prof. Antonio Prudente n° 211, São Paulo, SP 01509-010, Brazil; Laboratory for Endocrinology Cellular and Molecular - LIM25, University of São Paulo Medical School, Av. Dr. Arnaldo, 455, 4° andar, São Paulo, SP 01246-903, Brazil.
² Neuroendocrine Unit, Division of Endocrinology and Metabolism, Hospital das Clínicas, University of São Paulo Medical School, Avenida Enéas de Carvalho Aguiar, n° 155, 8° andar, bloco 03, São Paulo, São Paulo 05403-000, Brazil.
³ Neuroendocrine Unit, Division of Endocrinology and Metabolism, Hospital das Clínicas, University of São Paulo Medical School, Avenida Enéas de Carvalho Aguiar, n° 155, 8° andar, bloco 03, São Paulo, São Paulo 05403-000, Brazil. Electronic address: mdbronstein@uol.com.br.

PMID: 29754643
DOI: 10.1016/j.ecl.2018.02.004

Abstract

Progress in diagnosis and treatment of endocrine diseases has made pregnancy possible for women with endocrinopathies, including Cushing's syndrome (CS). The risk of maternal-fetal complications in patients who are not biochemically controlled, however, is substantial. Therefore, the surgical and/or medical control of hypercortisolism is mandatory prior to conceiving. A diagnosis of de novo CS during gestation is difficult due to changes in the hypothalamic-pituitary-adrenal axis during pregnancy, which may lead to some clinical features suggestive of CS along with abnormal laboratory tests. This review presents the diagnosis and management of CS during pregnancy.

Keywords: Cushing’s syndrome; Hypercortisolism; Pregnancy.

Publication types

Review

MeSH terms

Cushing Syndrome* / diagnosis
Cushing Syndrome* / drug therapy
Cushing Syndrome* / metabolism
Cushing Syndrome* / surgery
Female
Humans
Pregnancy
Pregnancy Complications* / drug therapy
Pregnancy Complications* / metabolism
Pregnancy Complications* / surgery