title: Pregnancies associated with primary adrenal insufficiency.
abstract: OBJECTIVE
  To provide a framework for the clinical presentation, evolution, treatment, and outcome of the unusual association between primary adrenal insufficiency (AI) during pregnancy and life-threatening complications for the mother and fetus.
  
  
  METHODS
  Case reports.
  
  
  METHODS
  Pregnant women with AI treated in the Endocrine and Diabetes Department, Hospital Universitario de Maternidad y Neonatología, Córdoba, Argentina.
  
  
  METHODS
  Three pregnant women with AI.
  
  
  METHODS
  Review of hospital records.
  
  
  METHODS
  Clinical, laboratory features, treatment, and outcome.
  
  
  RESULTS
  Two women with AI were diagnosed before conception, and one was diagnosed during gestation. Two of the cases were associated with other autoimmune diseases. Two newborns were born with signs of fetal distress, and one passed away hours later. Poor outcome was related to low compliance with treatment.
  
  
  CONCLUSIONS
  AI is often overlooked during pregnancy because of its rarity and pregnancy-like symptoms. Nevertheless, other autoimmune diseases, hyponatremia, metabolic acidosis, nausea and vomiting, and orthostatic hypotension that does not improve with usual treatment or persists after first trimester should evoke a diagnosis of AI. If diagnosis and treatment are properly managed, pregnancy, labor, and delivery may occur without complications. If not, AI is associated with high maternal and fetal morbidity and mortality.
authors: Departamento de Endocrinología y Diabetes, Hospital Universitario de Maternidad y Neonatología de Córdoba, Córdoba Capital, Argentina. endofux@yahoo.com.ar
authors: Carolina
authors: C
authors: Fux Otta
authors: Paula
authors: P
authors: Szafryk de Mereshian
authors: Gabriel Santino
authors: GS
authors: Iraci
authors: María Rosa
authors: MR
authors: Ojeda de Pruneda
mesh_terms: D000224:Addison Disease / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D000328:Adult; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000628:therapy*