Aron D C, Schnall A M, Sheeler L R
Department of Medicine, Case Western Reserve University, Cleveland, OH.
Am J Obstet Gynecol. 1990 Jan;162(1):244-52. doi: 10.1016/0002-9378(90)90859-6.
Pregnancy is a rare occurrence in women with Cushing's syndrome. Amenorrhea or oligomenorrhea occurs in about 75% of premenopausal women with Cushing's syndrome as a result of suppression of gonadotrophin secretion primarily by excess glucocorticoids. We have reviewed pregnancies in women with Cushing's syndrome (63 cases from the literature and four cases of our own). Since pregnant women without Cushing's syndrome develop some features of Cushing's syndrome, such as hypertension, hyperglycemia, and striae, a high index of clinical suspicion must be maintained to prevent delay in diagnosis. The physiologic changes in adrenocorticosteroid metabolism during pregnancy further complicate the diagnosis. Maternal and fetal risks increase markedly when pregnancy does occur in women with hypercortisolism. However, the wide spectrum of severity of the disease mandates an individualized approach to the therapy in each case.
库欣综合征女性怀孕较为罕见。约75%的绝经前库欣综合征女性会出现闭经或月经过少，这主要是由于过量糖皮质激素抑制促性腺激素分泌所致。我们回顾了库欣综合征女性的妊娠情况（文献报道63例，我们自己的病例4例）。由于无库欣综合征的孕妇也会出现一些库欣综合征的特征，如高血压、高血糖和妊娠纹，因此必须保持高度的临床怀疑指数以防止诊断延误。孕期肾上腺皮质类固醇代谢的生理变化使诊断更加复杂。患有皮质醇增多症的女性怀孕时，母婴风险会显著增加。然而，该疾病严重程度范围广泛，要求对每个病例采取个体化的治疗方法。
