Article

Cushing's syndrome in pregnancy with a severe maternal complication: a case report.

Department of Obstetrics and Gynecology, School of Medicine, Gyeongsang National University, Jinju, Korea.
Journal of Obstetrics and Gynaecology Research (impact factor: 0.94). 02/2011; 37(2):163-7. DOI:10.1111/j.1447-0756.2010.01339.x pp.163-7
Source: PubMed

ABSTRACT Cushing's syndrome (CS) in pregnancy may be confused with a complication of pregnancy, such as pre-eclampsia or gestational diabetes. We managed a case of CS in pregnancy that was considered to be severe pre-eclampsia due to uncontrolled hypertension. The fetus was delivered via emergency cesarean section at 31 weeks' gestation because of severe pre-eclampsia and pulmonary edema. The parturient was admitted to the intensive care unit for severe maternal complications, including pulmonary hemorrhage, acute renal failure, disseminated intravascular coagulopathy, and congestive heart failure. A spine magnetic resonance image and 99m-technetium whole-body scan obtained postpartum showed multiple thoracolumbar spine compression fractures (Deleted; t-2,5,8,10,11, and -12; and L-1,2,3,4, and -5), multiple rib fractures, and a left iliac bone fracture due to osteoporosis. As a result of diagnosing CS after delivery, an adrenal cortical adenoma of the right adrenal gland was demonstrated and a laparoscopic adrenalectomy was successfully performed.

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Keywords

31 weeks' gestation
 
99m-technetium whole-body scan
 
adrenal cortical adenoma
 
adrenal gland
 
Cushing's syndrome
 
disseminated intravascular coagulopathy
 
fetus
 
gestational diabetes
 
intensive care unit
 
laparoscopic adrenalectomy
 
left iliac bone fracture
 
multiple rib fractures
 
multiple thoracolumbar spine compression fractures
 
pulmonary edema
 
pulmonary hemorrhage
 
severe maternal complications
 
severe pre-eclampsia
 
spine magnetic resonance image
 

Won Jun Choi