Pregnancy in congenital adrenal hyperplasia
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Nicole Reisch [2] ; Richard J. Auchus [1]
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[1] University of Michigan–Ann Arbor
University of Michigan–Ann Arbor
City of Ann Arbor, Estados Unidos
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[2] Medizinische Klinik IV, Department of Endocrinology, Klinikum der Universität München, Ziemssenstraße 1, München 80336, Germany
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- Localización: Endocrinology and metabolism clinics of North America, ISSN 0889-8529, Vol. 53, Nº. 3, 2024 (Ejemplar dedicado a: Update on Endocrine Disorders During Pregnancy), págs. 391-407
- Idioma: inglés
- Enlaces
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Resumen
Fertility rates in classic congenital adrenal hyperplasia caused by 21-hydroxylase deficiency are substantially decreased for various reasons, including hormonal, anatomic, psychosocial, and psychosexual causes. However, fecundity is comparable with the general population. Under optimal hormone replacement, the course and outcome of pregnancies is also good. This article summarizes successful gestational management, including preconceptional considerations, adjustment of hormone replacement during pregnancy, delivery and lactation, as well as the prevention of adrenal crises. In nonclassic 21-hydroxylase deficiency, preconceptional low-dose hydrocortisone replacement normalizes the otherwise increased miscarriage rate. Pregnancy reports in rarer forms of congenital adrenal hyperplasia are summarized as well
