[Congenital adrenal hyperplasia and pregnancy].
About 90% of CAH cases are due to 21-hydroxylase (21-OH) deficiency. There are decreased cortisol and increased ACTH secretions; and elevated cortisol precursors and androgens. CAH is an important factor of menstrual disorders and infertility. Pregnancy is very much uncommon in the classic form, and 90% of reported cases belong to the postnatal form. The authors present two patients with classic form of CAH (21-OH deficiency) who became pregnant. They had been treated in early childhood (2-4 years old) with glucocorticoids and had surgical correction of the ambiguous external genitalia. During pregnancy, daily prednisone dose was raised to 5 mg twice, serum levels of 17-hydroxyprogesterone (17-OHP) and androgens were monthly measured. The 17-OHP levels remained high (about 1.6 ng/dl), and androgens (testosterone, androstenedione, SDHEA) levels remained normal. Cesarean section was performed in both cases; newborns were normal and 17-OHP was within normal limits. Adequate early replacement therapy has improved fertility and pregnancy.
Pardini
D P
DP
Kater
C E
CE
Vasserman
J
J
Baracat
E C
EC
Chacra
A R
AR
de Lima
G R
GR
D019326:17-alpha-Hydroxyprogesterone; D000312:Adrenal Hyperplasia, Congenital / Q000150:complications* / Q000188:drug therapy; D000328:Adult; D003900:Desoxycorticosterone / Q000172:deficiency; D005260:Female; D005312:Fetal Blood / Q000032:analysis; D006801:Humans; D006908:Hydroxyprogesterones / Q000097:blood; D007231:Infant, Newborn; D011241:Prednisone / Q000627:therapeutic use; D011247:Pregnancy; D011248:Pregnancy Complications
D006908:Hydroxyprogesterones; D003900:Desoxycorticosterone; D019326:17-alpha-Hydroxyprogesterone; D011241:Prednisone
Hiperplasia adrenal congênita e gravidez.