title: [Anesthesia for cesarean section in a patient with congenital adrenal hyperplasia: case report.].
abstract: OBJECTIVE
  The purpose of this case report is to illustrate the anesthetic management of a Cesarean section in a patient with non-classic congenital adrenal hyperplasia (CAH) and to review the clinical features and management of various forms of CAH during pregnancy.
  
  
  METHODS
  A 32-year-old primigravida, diagnosed with non-classic CAH, was admitted with intrauterine growth retardation at 28 weeks of gestation. Clinical features included morbid obesity, mild hypertension and chronic use of glucocorticoids. An emergency Cesarean section was performed at 29 weeks of gestation under uneventful spinal anesthesia with perioperative steroid coverage. Both mother and neonate had good outcome.
  
  
  CONCLUSIONS
  The management of patients with CAH presenting for labour or operative delivery should include the understanding of the effects of chronic steroid therapy, signs of adrenal insufficiency and perioperative steroid coverage. Anesthetic considerations should include issues related to obesity and hypertension. A multidisciplinary approach is required to ensure successful outcome.
authors.affiliation: Clinical and Research Fellow in Obstetric Anesthesia, Mount Sinai Hospital.
authors.forename: Mrinalini
authors.initials: M
authors.lastname: Balki
authors.forename: José Carlos Almeida
authors.initials: JC
authors.lastname: Carvalho
authors.forename: Carmencita
authors.initials: C
authors.lastname: Castro