[Hyperandrogenism and pregnancy].
Normal pregnancy is associated with high circulating levels of total testosterone explained by an increment of the synthesis of testosterone-estradiol-binding globulin (TeBG), and an increase in plasma free-testosterone and androstenedione levels. Protection mechanisms against maternal and fetal virilization conterbalance this biological hyperandrogenism. However, these mechanisms of protection may be overtaken leading to a maternal virilization during pregnancy. Acne, temporal balding, clitoromegaly and hirsutism could be observed. The most important point is to evaluate the risk of virilization of a female fetus. Earlier the hyperandrogenism occurs during pregnancy, higher is the risk of fetal virilization. The first step consists to identify a gestational exposition to androgen, the second to find an organic etiology. The most common etiologies include ovarian luteomas and theca-lutein-cysts. Others ovarian diseases (arrhenoblastomas, Krukenberg tumors and polycystic ovary syndrome) and adrenal causes are much more rare. Unfortunately, there is no treatment available during pregnancy.
Thorin-Savouré
A
A
Service d'endocrinologie et maladies métaboliques, CHU de Rouen, 147, avenue du Maréchal-Juin, 76230 Bois-Guillaume, France.
Kuhn
J M
JM
D000728:Androgens / Q000097:blood; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D017588:Hyperandrogenism / Q000503:physiopathology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000503:physiopathology*; D013739:Testosterone / Q000097:blood
D000728:Androgens; D013739:Testosterone; D004958:Estradiol