Volume 3, Issue 1 (2018)                   SJMR 2018, 3(1): 85-89 | Back to browse issues page


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Almasi Nasrabadi M, Mirarmandehi S, Roostaee Z. Cushing’s Syndrome in a Pregnant Woman. SJMR. 2018; 3 (1) :85-89
URL: http://saremjrm.com/article-1-101-en.html
1- Sarem Fertility & Infertility Research Center (SAFIR), Sarem Women’s Hospital, Tehran, Iran , Zrmj1394@gmail.com
2- Sarem Fertility & Infertility Research Center (SAFIR), Sarem Women’s Hospital, Tehran, Iran
Abstract:   (5247 Views)

Patient Information: Pregnancy is rare in most women with Cushing's syndrome (CS) due to the lack of ovulation. A 36-year-old woman, who had experienced cesarean section in her first pregnancy and her second pregnancy had occurred despite the Intrauterine Device (IUD), was referred to the hospital. The results of routine pregnancy tests and screening tests indicated normal general conditions. At the 12th week of pregnancy, the first manifestation of blood pressure was observed. During the pregnancy, the patient was constantly monitored and, finally, at the 34th week, she underwent cesarean section due to the severity of symptoms, cesarean section history, and delayed fetal infarction. A boy was born, weighing 1700 grams and was hospitalized in the NICU ward. Regarding the lack of control of blood pressure after pregnancy, an abdominal MRI was asked for the patient to examine the renal artery; a 3cm mass was reported in her right adrenal, and a diagnosis of Cushing's syndrome was presented to her. The right laparoscopic adrenalectomy was conducted for the patient and gradually the Corton intake was stopped. After the recent procedures, all of the patient’s symptoms, including hypertension, edema, proteinuria, hyperglycemia, and hyperlipidemia were resolved. Proximal muscles pain and weakness remained about 1 year after her laparoscopic adrenalectomy, and they were improved by physiotherapy.
Conclusion: Secondary hypertension can occur due to Renovascular hypertension, pheochromocytoma, and Cushing’s syndrome. Although Cushing's syndrome is rare in pregnancy, these cases can be accompanied by hypertension, preeclampsia, preterm labor, and fetal loss. Therefore, a more complete assessment and attention to important symptoms such as blood pressure is necessary to prevent the complications.

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Article Type: Case Report | Subject: Reproduction
Received: 2016/12/21 | Accepted: 2017/05/19 | Published: 2018/05/22

References
1. Eschler DC, Kogekar N, Pessah-Pollack R. Management of adrenal tumors in pregnancy. Endocrinol Metab Clin North Am. 2015;44(2):381-97. [Link] [DOI:10.1016/j.ecl.2015.02.006] [PMID]
2. Katulski K, Podfigurna-Stopa A, Maciejewska-Jeske M, Ruchala M, Gurgul E, Szymankiewicz M, et al. Cushing's syndrome in pregnancy: A case report and mini review of the literature. Gynecol Endocrinol. 2014;30(5):345-9. [Link] [DOI:10.3109/09513590.2013.879857] [PMID]
3. Sammour RN, Saiegh L, Matter I, Gonen R, Shechner C, Cohen M, et al. Adrenalectomy for adrenocortical adenoma causing Cushing's syndrome in pregnancy: A case report and review of literature. Eur J Obstet Gynecol Reprod Biol. 2012;165(1):1-7. [Link] [DOI:10.1016/j.ejogrb.2012.05.030] [PMID]
4. Lekarev O, New MI. Adrenal disease in pregnancy. Best Pract Res Clin Endocrinol Metab. 2011;25(6):959-73. [Link] [DOI:10.1016/j.beem.2011.08.004] [PMID]
5. Borna S, Akbari S, Eftekhar T, Mostaan F. Cushing's syndrome during pregnancy secondary to adrenal adenoma. Acta Med Iran. 2012;50(1):76. [Link] [PMID]
6. Nassi R, Ladu C, Vezzosi C, Mannelli M. Cushing's syndrome in pregnancy. Gynecol Endocrinol. 2015;31(2):102-4. [Link] [DOI:10.3109/09513590.2014.984680] [PMID]
7. Kita M, Sakalidou M, Saratzis A, Ioannis S, Avramides A. Cushing's syndrome in pregnancy: Report of a case and review of the literature. Horm. 2007;6(3):242-6. [Link]
8. Achong N, D'EMDEN M, Fagermo N, Mortimer R. Pregnancy-induced Cushing's syndrome in recurrent pregnancies: Case report and literature review. Aust N Z J Obstet Gynaecol. 2012;52(1):96-100. [Link] [DOI:10.1111/j.1479-828X.2011.01388.x] [PMID]
9. Abdelmannan D, Aron DC. Adrenal disorders in pregnancy. Endocrinol Metab Clin North Am. 2011;40(4):779-94. [Link] [DOI:10.1016/j.ecl.2011.09.001] [PMID]
10. Lim WH, Torpy DJ, Jeffries WS. The medical management of Cushing's syndrome during pregnancy. Eur J Obstet Gynecol Reprod Biol. 2013;168(1):1-6 [Link] [DOI:10.1016/j.ejogrb.2012.12.015] [PMID]
11. Esteghamati A, Eshtiaghi R, Yousefizadeh A, Nakhjavani M. Diagnosis and management of 253 Cases with Cushing's syndrome in Imam Khomeini Hospital. Tehran Univ Med J. 2007;65(7):77-82. [Link]
12. Vilar L, Freitas MdC, Lima LHC, Lyra R, Kater CE. Cushing's syndrome in pregnancy: An overview. Arq Bras Endocrinol Metabol. 2007;51(8):1293-302. [Link] [DOI:10.1590/S0004-27302007000800015]
13. Phoon J, Kanalingam D, Chua HL. Adrenal tumours in pregnancy: Diagnostic challenge and management dilemma. Singapore Med J. 2013;54(7):e141-5. [Link] [DOI:10.11622/smedj.2013068] [PMID]
14. Bronstein M, Machado MC, Fragoso MCBV. Management of endocrine disease: Management of pregnant patients with Cushing's syndrome. Eur J Endocrinol. 2015;173(2):R85-91. [Link] [DOI:10.1530/EJE-14-1130] [PMID]
15. Aron DC, Schnall AM, Sheeler LR. Cushing's syndrome and pregnancy. Am J Obstet Gynecol. 1990;162(1):244-52. [Link] [DOI:10.1016/0002-9378(90)90859-6]

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