Endocrine Abstracts

Cushing’s Syndrome (CS) is an uncommon disease worldwide, being characterized by an increased production of glucocorticoids, and if left untreated can lead to serious consequences and women with CS rarely get pregnant. The aim of our work is to make a systematic review of the cases of pregnancy in patients with previously diagnosed CS, being performed an extensive research of the Medline and Web of Knowledge databases, and add three new cases observed in our institution. We compared two different groups: the ‘active disease’ one and the ‘non-active disease’ and we found 17 pregnancies that were included in the first group while other 20 pregnancies were in the second category. We observed two spontaneous abortions and one ectopic pregnancy in the ‘active’ group, while in the ‘non-active’ category we found the same number of spontaneous abortions besides a placental abruption and a medical interruption of the pregnancy. Cushing disease (CD) was the main cause behind CS (28 pregnancies), with transsphenoidal surgery the preferred treatment. Within the ‘active’ category, we reported nine full-term and five pre-term pregnancies and in the ‘non-active’ category we observed 11 full-term and three pre-term pregnancies, while two in this last group were non-specified. Hypertension was diagnosed in eight cases (six and two in the ‘active’ and ‘non-active’ group respectively) and gestational diabetes in four patients (three and one in the ‘active’ and ‘non-active’ categories). Inability to breastfeed was one of the main perinatal events reported, as a logical consequence of the treatment regimen adopted for CS. A major concern in these patients refers to the medical control of CS activity, because hypercortisolism occurs physiologically during pregnancy. This is a topic with extreme clinical significance since it is rare that a CS women conceives.