Surgery for Cushings Disease in Pregnancy

Cushings syndrome (CS) in pregnancy is a rare phenomenon and as a result there is limited literature on its management. Cushings disease (CD) in pregnancy is even less common and there is little guidance to help treat this patient group. Diagnosis of CS in pregnancy is often delayed due to overlap of symptoms. In addition, there are no validated diagnostic tests or parameters documented due to limited experience. We present a case of a 30 year old female presenting to antenatal clinic 13 weeks pregnant with high suspicion of Cushings disease. Her 21 week foetal scan showed a congenital diaphragmatic hernia and she underwent MRI pituitary confirming CD. She successfully underwent transsphenodial adenomectomy with histology confirming a corticotroph adenoma. Tests following her transsphenoidal surgery confirmed remission of CD and she underwent an emergency C-section at 38 weeks. Unfortunately, her baby died from complications associated with the congenital abnormality after 36 hours of birth. The patient remains in remission following delivery. Till now there have been no reported case of congenital diaphragmatic hernia associated with CD in pregnancy. In addition, we believe that we are the eighth reported case to have undertaken successful transsphenoidal surgery in CD in pregnancy.

Read More

http://pregnancyready.com/surgery-for-cushings-disease-in-pregnancy/