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Pregnancy is a rare occurrence in women with Cushing's syndrome. Amenorrhea or oligomenorrhea
occurs in about 75% of premenopausal women with Cushing's syndrome as a result of
suppression of gonadotropin secretion primarily by excess glucocorticoids. We have
reviewed pregnancies in women with Cushing's syndrome (63 cases from the literature
and four cases of our own). Since pregnant women without Cushing's syndrome develop
some features of Cushing's syndrome, such as hypertension, hyperglycemia, and striae,
a high index of clinical suspicion must be maintained to prevent delay in diagnosis.
The physiologic changes in adrenocorticosteroid metabolism during pregnancy further
complicate the diagnosis. Maternal and fetal risks increase markedly when pregnancy
does occur in women with hypercortisolism. However, the wide spectrum of severity
of the disease mandates an individualized approach to the therapy in each case. (AM
J OBsTET GYNECOL 1990;162:244-52.)
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© 1990 Mosby. Published by Elsevier Inc. All rights reserved.
