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16 - Rare endocrine disorders

from Section 4 - Metabolic disorders

Published online by Cambridge University Press:  19 October 2009

By
J. M. Mhyre  and
L. S. Polley
Edited by
David R. Gambling ,
M. Joanne Douglas  and
Robert S. F. McKay
J. M. Mhyre
Affiliation:
Robert Wood Johnson Clinical Scholar, Lecturer, Department of Anesthesiology, Division of Obstetrical Anesthesiology
L. S. Polley
Affiliation:
Associate Professor of Anesthesiology, Director, Obstetric Anesthesiology, University of Michigan, Health System F3900, Mott Children's Hospital, Ann Arbor, MI, USA
David R. Gambling
Affiliation:
University of California, San Diego
M. Joanne Douglas
Affiliation:
University of British Columbia, Vancouver
Robert S. F. McKay
Affiliation:
University of Kansas
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Summary

Introduction

Endocrinopathies can complicate pregnancy with adverse maternal and fetal effects. Pregnancy can mask or mimic signs and symptoms of endocrine disease making diagnosis difficult.

Thyroid disease

Hyperthyroidism

Hyperthyroidism is relatively common in the general population and occurs in 2 of 1000 pregnancies. Graves disease causes 80–95% of cases of hyperthyroidism in pregnancy. Other causes include thyroiditis, toxic adenoma, multinodular goiter, viral thyroiditis, and tumors of the pituitary or ovary. Human chorionic gonadotropin (hCG), which peaks between 8 and 14 weeks, weakly stimulates thyroid stimulating hormone (TSH) receptors, and in some cases leads to transient hyperthyroidism associated with hyperemesis gravidarum. High levels of hCG with clinical hyperthyroidism may also be seen with gestational trophoblastic disease and multiple pregnancies.

Subclinical hyperthyroidism occurs in pregnancy (1.7% of all screened women), and, in the general population, has long-term sequelae such as osteoporosis, cardiovascular morbidity, and progression to overt thyrotoxicosis. These women have suppressed TSH but normal free thyroxine (T4) levels. African-American and parous women are more likely to be affected, but there are no adverse pregnancy outcomes. Identification of subclinical hyperthyroidism and treatment during pregnancy is unwarranted.

Thyrotoxic crisis (thyroid storm)

Thyroid storm is the most serious complication of hyperthyroidism. This exaggerated hypermetabolic state occurs in 2% of pregnancies complicated by hyperthyroidism with a reported maternal mortality rate of 15% and a 24% rate of stillbirth. Thyroid storm is often precipitated in women with Graves thyrotoxicosis by common obstetric complications such as hemorrhage, severe preeclampsia, and sepsis.

Type
Chapter
Information
Obstetric Anesthesia and Uncommon Disorders , pp. 275 - 292
Publisher: Cambridge University Press
Print publication year: 2008

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References

Casey, B. M. & Leveno, K. J.Thyroid disease in pregnancy. Obstet. Gynecol. 2006; 108: 1283–92.Google Scholar
Lazarus, J. H.Thyroid disorders associated with pregnancy: etiology, diagnosis, and management. Treat. Endocrinol. 2005; 4: 31–41.Google Scholar
Casey, B. M., Dashe, J. S., Wells, C. E.et al. Subclinical hyperthyroidism and pregnancy outcomes. Obstet. Gynecol. 2006; 107: 337–41.Google Scholar
Sheffield, J. S. & Cunningham, F. G.Thyrotoxicosis and heart failure that complicate pregnancy. Am. J. Obstet. Gynecol. 2004; 190: 211–17.Google Scholar
Reid, A. W., Warmington, A. D. & Wilkinson, L. M.Management of a pregnant patient with airway obstruction secondary to goitre. Anaesth. Intensive Care 1999; 27: 415–17.Google Scholar
Kaplan, J. A. & Cooperman, L. H.Alarming reactions to ketamine in patients taking thyroid medication – treatment with propranolol. Anesthesiology 1971; 35: 229–30.Google Scholar
Halpern, S. H.Anaesthesia for caesarean section in patients with uncontrolled hyperthyroidism. Can. J. Anaesth. 1989; 36: 454–9.Google Scholar
Maze, M.Clinical implications of membrane receptor function in anesthesia. Anesthesiology 1981; 55: 160–71.Google Scholar
Peters, K. R., Nance, P. & Wingard, D. W.Malignant hyperthyrodism or malignant hyperthermia?Anesth. Analg. 1981; 60: 613–15.Google Scholar
Pugh, S., Lalwani, K. & Awal, A.Thyroid storm as a cause of loss of consciousness following anaesthesia for emergency caesarean section. Anaesthesia 1994; 49: 35–7.Google Scholar
Wartofsky, L., Nostrand, D. & Burman, K. D.Overt and ‘subclinical’ hypothyroidism in women. Obstet. Gynecol. Surv. 2006; 61: 535–42.Google Scholar
Michiels, J. J., Schroyens, W., Berneman, Z. & Planken, M.Acquired von Willebrand syndrome type 1 in hypothyroidism: reversal after treatment with thyroxine. Clin. Appl. Thromb. Hemost. 2001; 7: 113–15.Google Scholar
Haddow, J. E., Palomaki, G. E., Allan, W. C.et al. Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. N. Engl. J. Med. 1999; 341: 549–55.Google Scholar
Alexander, E. K., Marqusee, E., Lawrence, J.et al. Timing and magnitude of increases in levothyroxine requirements during pregnancy in women with hypothyroidism. N. Engl. J. Med. 2004; 351: 241–9.Google Scholar
Anselmo, J., Cao, D., Karrison, T.et al. Fetal loss associated with excess thyroid hormone exposure. J.A.M.A. 2004; 292: 691–5.Google Scholar
Casey, B. M., Dashe, J. S., Wells, C. E.et al. Subclinical hypothyroidism and pregnancy outcome. Obstet. Gynecol. 2005; 105: 239–45.Google Scholar
Surks, M. I., Ortiz, E., Daniels, G. H.et al. Subclinical thyroid disease: scientific review and guidelines for diagnosis and management. J. A. M. A. 2004; 291: 228–38.Google Scholar
Miller, L. R., Benumof, J. L., Alexander, L.et al. Completely absent response to peripheral nerve stimulation in an acutely hypothyroid patient. Anesthesiology 1989; 71: 779–81.Google Scholar
Surks, M. I. & Sievert, R.Drugs and thyroid function. N. Engl. J. Med. 1995; 333: 1688–94.Google Scholar
Basaria, S. & Cooper, D. S.Amiodarone and the thyroid. Am. J. Med. 2005; 118: 706–14.Google Scholar
Nachum, Z., Rakover, Y., Weiner, E. & Shalev, E.Graves' disease in pregnancy: prospective evaluation of a selective invasive treatment protocol. Am. J. Obstet. Gynecol. 2003; 189: 159–65.Google Scholar
Carroll, M. A. & Yeomans, E. R.Diabetic ketoacidosis in pregnancy. Crit. Care Med. 2005; 33: S347–53.Google Scholar
Kamalakannan, D., Baskar, V., Barton, D. M. & Abdu, T. A.Diabetic ketoacidosis in pregnancy. Postgrad. Med. J. 2003; 79: 454–7.Google Scholar
Selitsky, T., Chandra, P. & Schiavello, H. J.Wernicke's encephalopathy with hyperemesis and ketoacidosis. Obstet. Gynecol. 2006; 107: 486–90.Google Scholar
Evers, I. M., Braak, E. W., Valk, H. W.et al. Risk indicators predictive for severe hypoglycemia during the first trimester of type 1 diabetic pregnancy. Diabetes Care 2002; 25: 554–9.Google Scholar
Rosenn, B. M., Miodovnik, M., Holcberg, G.et al. Hypoglycemia: the price of intensive insulin therapy for pregnant women with insulin-dependent diabetes mellitus. Obstet. Gynecol. 1995; 85: 417–22.Google Scholar
Yogev, Y., Ben-Haroush, A., Chen, R.et al. Undiagnosed asymptomatic hypoglycemia: diet, insulin, and glyburide for gestational diabetic pregnancy. Obstet. Gynecol. 2004; 104: 88–93.Google Scholar
Crites, J. & Ramanathan, J.Acute hypoglycemia following combined spinal–epidural anesthesia (CSE) in a parturient with diabetes mellitus. Anesthesiology 2000; 93: 591–2.Google Scholar
Reece, E. A., Homko, C. J. & Wiznitzer, A.Hypoglycemia in pregnancies complicated by diabetes mellitus: maternal and fetal considerations. Clin. Obstet. Gynecol. 1994; 37: 50–8.Google Scholar
Kimmerle, R., Heinemann, L., Delecki, A. & Berger, M.Severe hypoglycemia incidence and predisposing factors in 85 pregnancies of type I diabetic women. Diabetes Care 1992; 15: 1034–7.Google Scholar
Eastwood, D. W.Anterior spinal artery syndrome after epidural anesthesia in a pregnant diabetic patient with scleredema. Anesth. Analg. 1991; 73: 90–1.Google Scholar
Raziel, A., Schreyer, P., Zabow, P.et al. Hyperglycaemic hyperosmolar syndrome complicating severe pregnancy-induced hypertension. Case report. Br. J. Obstet. Gynaecol. 1989; 96: 1355–6.Google Scholar
Scheithauer, B. W., Sano, T., Kovacs, K. T.et al. The pituitary gland in pregnancy: a clinicopathologic and immunohistochemical study of 69 cases. Mayo Clin. Proc. 1990; 65: 461–74.Google Scholar
Ahmed, M., al-Dossary, E. & Woodhouse, N. J.Macroprolactinomas with suprasellar extension: effect of bromocriptine withdrawal during one or more pregnancies. Fertil. Steril. 1992; 58: 492–7.Google Scholar
Casanueva, F. F., Molitch, M. E., Schlechte, J. A.et al. Guidelines of the Pituitary Society for the diagnosis and management of prolactinomas. Clin. Endocrinol. 2006; 65: 265–73.Google Scholar
Molitch, M. E.Management of prolactinomas during pregnancy. J. Reprod. Med. 1999; 44: 1121–6.Google Scholar
Liu, C. & Tyrrell, J. B.Successful treatment of a large macroprolactinoma with cabergoline during pregnancy. Pituitary 2001; 4: 179–85.Google Scholar
Sam, S. & Molitch, M. E.Timing and special concerns regarding endocrine surgery during pregnancy. Endocrinol. Metab. Clin. North Am. 2003; 32: 337–54.Google Scholar
Herman-Bonert, V., Seliverstov, M. & Melmed, S.Pregnancy in acromegaly: successful therapeutic outcome. J. Clin. Endocrinol. Metab. 1998; 83: 727–31.Google Scholar
Neal, J. M.Successful pregnancy in a woman with acromegaly treated with octreotide. Endocr. Pract. 2000; 6: 148–50.Google Scholar
Seidman, P. A., Kofke, W. A., Policare, R. & Young, M.Anaesthetic complications of acromegaly. Br. J. Anaesth. 2000; 84: 179–82.Google Scholar
Schmitt, H., Buchfelder, M., Radespiel-Troger, M. & Fahlbusch, R.Difficult intubation in acromegalic patients: incidence and predictability. Anesthesiology 2000; 93: 110–14.Google Scholar
Burch, W. M.Normal menstruation and pregnancy in a patient with Nelson's syndrome. South Med. J. 1983; 76: 1319–20.Google Scholar
Surrey, E. S. & Chang, R. J.Nelson's syndrome in pregnancy. Fertil. Steril. 1985; 44: 548–51.Google Scholar
Igoe, D., Pidgeon, C., Dinn, J. & McKenna, T. J.Nelson's syndrome following partial pituitary microadenomectomy and pregnancy. Clin. Endocrinol. 1992; 36: 429–32.Google Scholar
Durr, J. A. & Lindheimer, M. D.Diagnosis and management of diabetes insipidus during pregnancy. Endocr. Pract. 1996; 2: 353–61.Google Scholar
Hamai, Y., Fujii, T., Nishina, H.et al. Differential clinical courses of pregnancies complicated by diabetes insipidus which does, or does not, pre-date the pregnancy. Hum. Reprod. 1997; 12: 1816–18.Google Scholar
Goolsby, L. & Harlass, F.Central diabetes insipidus: a complication of ventriculoperitoneal shunt malfunction during pregnancy. Am. J. Obstet. Gynecol. 1996; 174: 1655–7.Google Scholar
Kallen, B. A., Carlsson, S. S. & Bengtsson, B. K.Diabetes insipidus and use of desmopressin (Minirin) during pregnancy. Eur. J. Endocrinol. 1995; 132: 144–6.Google Scholar
Ray, J. G.DDAVP use during pregnancy: an analysis of its safety for mother and child. Obstet. Gynecol. Surv. 1998; 53: 450–5.Google Scholar
Passannante, A. N., Kopp, V. J. & Mayer, D. C.Diabetes insipidus and epidural analgesia for labor. Anesth. Analg. 1995; 80: 837–8.Google Scholar
Lacassie, H. J., Muir, H. A., Millar, S. & Habib, A. S.Perioperative anesthetic management for Cesarean section of a parturient with gestational diabetes insipidus. Can. J. Anaesth. 2005; 52: 733–6.Google Scholar
Lurie, S., Feinstein, M. & Mamet, Y.Symptomatic hyponatremia following cesarean section. J. Matern. Fetal Neonatal Med. 2002; 11: 138–9.Google Scholar
Overton, C. E., Davis, C. J., West, C.et al. High risk pregnancies in hypopituitary women. Hum. Reprod. 2002; 17: 1464–7.Google Scholar
Buckland, R. H. & Popham, P. A.Lymphocytic hypophysitis complicated by post-partum haemorrhage. Int. J. Obstet. Anesth. 1998; 7: 263–6.Google Scholar
Kelestimur, F.Sheehan's syndrome. Pituitary 2006; 6: 181–8.Google Scholar
Grimes, H. G. & Brooks, M. H.Pregnancy in Sheehan's syndrome. Report of a case and review. Obstet. Gynecol. Surv. 1980; 35: 481–8.Google Scholar
Grodski, S., Jung, C., Kertes, P., Davies, M. & Banting, S.Phaeochromocytoma in pregnancy. Intern. Med. J. 2006; 36: 604–6.Google Scholar
Bravo, E. L. & Tagle, R.Pheochromocytoma: state-of-the-art and future prospects. Endocr. Rev. 2003; 24: 539–53.Google Scholar
Neumann, H. P., Berger, D. P., Sigmund, G.et al. Pheochromocytomas, multiple endocrine neoplasia type 2, and von Hippel-Lindau disease. N. Engl. J. Med. 1993; 329: 1531–8.Google Scholar
Skinner, M. A., Moley, J. A., Dilley, W. G.et al. Prophylactic thyroidectomy in multiple endocrine neoplasia type 2 A. N. Engl. J. Med. 2005; 353: 1105–13.Google Scholar
Botchan, A., Hauser, R., Kupfermine, M.et al. Pheochromocytoma in pregnancy: case report and review of the literature. Obstet. Gynecol. Surv. 1995; 50: 321–7.Google Scholar
Stenstrom, G., Haljamae, H. & Tisell, L. E.Influence of pre-operative treatment with phenoxybenzamine on the incidence of adverse cardiovascular reactions during anaesthesia and surgery for phaeochromocytoma. Acta Anaesthesiol. Scand. 1985; 29: 797–803.Google Scholar
Kamari, Y., Sharabi, Y., Leiba, A.et al. Peripartum hypertension from phaeochromocytoma: a rare and challenging entity. Am. J. Hypertens. 2005; 18: 1306–12.Google Scholar
Hudsmith, J. G., Thomas, C. E. & Browne, D. A.Undiagnosed phaeochromocytoma mimicking severe preeclampsia in a pregnant woman at term. Int. J. Obstet. Anesth. 2006; 15: 240–5.Google Scholar
Swiet, M. Other indirect deaths. In: Confidential Enquiry into Maternal and Child Health. Why Mothers Die 2000–2002. The Sixth Report of the Confidential Enquiries into Maternal Death in the United Kingdom 2000–2002. London: RCOG Press, 2004.
Strachan, A. N., Claydon, P. & Caunt, J. A.Phaeochromocytoma diagnosed during labour. Br. J. Anaesth. 2000; 85: 635–7.Google Scholar
Gill, P. S.Acute heart failure in the parturient – do not forget phaeochromocytoma. Anaesth. Intensive Care. 2000; 28: 322–4.Google Scholar
Kim, J., Reutrakul, S., Davis, D. B.et al. Multiple endocrine neoplasia 2 A syndrome presenting as peripartum cardiomyopathy due to catecholamine excess. Eur. J. Endocrinol. 2004; 151: 771–7.Google Scholar
Cermakova, A., Knibb, A. A., Hoskins, C. & Menon, G.Postpartum phaeochromocytoma. Int. J. Obstet. Anesth. 2003; 12: 300–4.Google Scholar
New, F. C. & Candelier, C. K.Phaeochromocytoma – an unusual cause of fitting in pregnancy. J. Obstet. Gynaecol. 2003; 23: 203–4.Google Scholar
Bullough, A., Karadia, S. & Watters, M.Phaeochromocytoma: an unusual cause of hypertension in pregnancy. Anaesthesia 2001; 56: 43–6.Google Scholar
Witteles, R. M., Kaplan, E. L. & Roizen, M. F.Safe and cost-effective preoperative preparation of patients with pheochromocytoma. Anesth. Analg. 2000; 91: 302–4.Google Scholar
Sawka, A. M., Jaeschke, R., Singh, R. J. & Young, W. F. Jr.A comparison of biochemical tests for pheochromocytoma: measurement of fractionated plasma metanephrines compared with the combination of 24-hour urinary metanephrines and catecholamines. J. Clin. Endocrinol. Metab. 2003; 88: 553–8.Google Scholar
Kocak, S., Aydintug, S. & Canakci, N.Alpha blockade in preoperative preparation of patients with pheochromocytomas. Int. Surg. 2002; 87: 191–4.Google Scholar
Prys-Roberts, C. & Farndon, J. R.Efficacy and safety of doxazosin for perioperative management of patients with pheochromocytoma. World J. Surg. 2002; 26: 1037–42.Google Scholar
Pace, D. E., Chiasson, P. M., Schlachta, C. M.et al. Minimally invasive adrenalectomy for pheochromocytoma during pregnancy. Surg. Laparosc. Endosc. Percutan. Tech. 2002; 12: 122–5.Google Scholar
Miller, C., Bernet, V., Elkas, J. C., Dainty, L. & Gherman, R. B.Conservative management of extra-adrenal pheochromocytoma during pregnancy. Obstet. Gynecol. 2005; 105: 1185–8.Google Scholar
Saarikoski, S.Fate of noradrenaline in the human foetoplacental unit. Acta Physiol. Scand. Suppl. 1974; 421: 1–82.Google Scholar
Santeiro, M. L., Stromquist, C. & Wyble, L.Phenoxybenzamine placental transfer during the third trimester. Ann. Pharmacother. 1996; 30: 1249–51.Google Scholar
Aplin, S. C., Yee, K. F. & Cole, M. J.Neonatal effects of long-term maternal phenoxybenzamine therapy. Anesthesiology 2004; 100: 1608–10.Google Scholar
Davies, A. E. & Navaratnarajah, M.Vaginal delivery in a patient with a phaeochromocytoma. A case report. Br. J. Anaesth. 1984; 56: 913–16.Google Scholar
Cammarano, W. B., Gray, A. T., Rosen, M. A. & Lim, K. H.Anesthesia for combined cesarean section and extra-adrenal pheochromocytoma resection: a case report and literature review. Int. J. Obstet. Anesth. 1997; 6: 112–17.Google Scholar
Hamilton, A., Sirrs, S., Schmidt, N. & Onrot, J.Anaesthesia for phaeochromocytoma in pregnancy. Can. J. Anaesth. 1997; 44: 654–7.Google Scholar
James, M. F.Use of magnesium sulphate in the anaesthetic management of phaeochromocytoma: a review of 17 anaesthetics. Br. J. Anaesth. 1989; 62: 616–23.Google Scholar
James, M. F. & Cronje, L.Pheochromocytoma crisis: the use of magnesium sulfate. Anesth. Analg. 2004; 99: 680–6.Google Scholar
James, M. F.Magnesium in obstetric anesthesia. Int. J. Obstet. Anesth. 1998; 7: 115–23.Google Scholar
Nieman, L. K. & Turner, Chanco M. L.Addison's disease. Clin. Dermatol. 2006; 24: 276–80.Google Scholar
Migeon, C. J. & Lanes, R. L. Adrenal cortex: hypo- and hyperfunction. In Lifshitz, F. (ed.), Pediatric Endocrinology: A Clinical Guide. New York, NY: Marcel Dekker, 1990; pp. 147–74.
Gaither, K., Wright, R., Apuzzio, J. J.et al. Pregnancy complicated by autoimmune polyglandular syndrome type II: a case report. J. Matern. Fetal Med. 1998; 7: 154–6.Google Scholar
Stechova, K., Bartaskova, D., Mrstinova, M.et al. Pregnancy in a woman suffering from type 1 diabetes associated with Addison's disease and Hashimoto's thyroiditis (fully developed Autoimmune Polyglandular Syndrome Type 2). Exp. Clin. Endocrinol. Diabetes 2004; 112: 333–7.Google Scholar
Yarnell, R. W., D'Alton, M. E. & Steinbok, V. S.Pregnancy complicated by preeclampsia and adrenal insufficiency. Anesth. Analg. 1994; 78: 176–8.Google Scholar
Brown, L. S. Jr., Singer, F. & Killian, P.Endocrine complications of AIDS and drug addiction. Endocrinol. Metab. Clin. North Am. 1991; 20: 655–73.Google Scholar
Ozdemir, I., Demirci, F., Yucel, O., Simsek, E. & Yildiz, I.A case of primary Addison's disease with hyperemesis gravidarum and successful pregnancy. Eur. J. Obstet. Gynecol. Reprod. Biol. 2004; 113: 100–2.Google Scholar
Adonakis, G., Georgopoulos, N. A., Michail, G.et al. Successful pregnancy outcome in a patient with primary Addison's disease. Gynecol. Endocrinol. 2005; 21: 90–2.Google Scholar
Ambrosi, B., Barbetta, L. & Morricone, L.Diagnosis and management of Addison's disease during pregnancy. J. Endocrinol. Invest. 2003; 26: 698–702.Google Scholar
Afzai, A. & Khaja, F.Reversible cardiomyopathy associated with Addison's disease. Can. J. Cardiol. 2000; 16: 377–9.Google Scholar
Geller, D. S.Mineralocorticoid resistance. Clin. Endocrinol. 2005; 62: 513–20.Google Scholar
Geller, D. S., Zhang, J., Zennaro, M. C.et al. Autosomal dominant pseudohypoaldosteronism type 1: mechanisms, evidence for neonatal lethality, and phenotypic expression in adults. J. Am. Soc. Nephrol. 2006; 17: 1429–36.Google Scholar
Delibasi, T., Ustun, I., Aydin, Y.et al. Early severe pre-eclamptic findings in a patient with Cushing's syndrome. Gynecol. Endocrinol. 2006; 22: 710–12.Google Scholar
Orth, D. N.Cushing's syndrome. N. Engl. J. Med. 1995; 332: 791–803.Google Scholar
Aron, D. C., Schnall, A. M. & Sheeler, L. R.Cushing's syndrome and pregnancy. Am. J. Obstet. Gynecol. 1990; 162: 244–52.Google Scholar
Lindsay, J. R., Jonklaas, J., Oldfield, E. H. & Nieman, L. K.Cushing's syndrome during pregnancy: personal experience and review of the literature. J. Clin. Endocrinol. Metab. 2005; 90: 3077–83.Google Scholar
Fayol, L., Masson, P., Millet, V. & Simeoni, U.Cushing's syndrome in pregnancy and neonatal hypertrophic obstructive cardiomyopathy. Acta Paediatr. 2004; 93: 1400–2.Google Scholar
Buescher, M. A., McClamrock, H. D. & Adashi, E. Y.Cushing syndrome in pregnancy. Obstet. Gynecol. 1992; 79: 130–7.Google Scholar
Tajika, T., Shinozaki, T., Watanabe, H.et al. Case report of a Cushing's syndrome patient with multiple pathologic fractures during pregnancy. J. Orthop. Sci. 2002; 7: 498–500.Google Scholar
Lo, C. Y., Lo, C. M. & Lam, K. Y.Cushing's syndrome secondary to adrenal adenoma during pregnancy. Surg. Endosc. 2002; 16: 219–20.Google Scholar
Shaw, J. A., Pearson, D. W., Krukowski, Z. H.et al. Cushing's syndrome during pregnancy: curative adrenalectomy at 31 weeks' gestation. Eur. J. Obstet. Gynecol. Reprod. Biol. 2002; 105: 189–91.Google Scholar
Mellor, A., Harvey, R. D., Pobereskin, L. H. & Sneyd, J. R.Cushing's disease treated by trans-sphenoidal selective adenomectomy in mid-pregnancy. Br. J. Anaesth. 1998; 80: 850–2.Google Scholar
Hana, V., Dokoupilova, M., Marek, J. & Plavka, R.Recurrent ACTH-independent Cushing's syndrome in multiple pregnancies and its treatment with metyrapone. Clin. Endocrinol. 2001; 54: 277–81.Google Scholar
Berwaerts, J., Verhelst, J., Mahler, C. & Abs, R.Cushing's syndrome in pregnancy treated by ketoconazole: case report and review of the literature. Gynecol. Endocrinol. 1999; 13: 175–82.Google Scholar
Glassford, J., Eagle, C. & McMorland, G. H.Caesarean section in a patient with Cushing's syndrome. Can. Anaesth. Soc. J. 1984; 31: 447–50.Google Scholar
Okawa, T., Asano, K., Hashimoto, T.et al. Diagnosis and management of primary aldosteronism in pregnancy: case report and review of the literature. Am. J. Perinatol. 2002; 19: 31–6.Google Scholar
Ganguly, A.Primary aldosteronism. N. Engl. J. Med. 1998; 339: 1828–34.Google Scholar
Wyckoff, J. A., Seely, E. W., Hurwitz, S.et al. Glucocorticoid-remediable aldosteronism and pregnancy. Hypertension 2000; 35: 668–72.Google Scholar
New, M. I.Antenatal diagnosis and treatment of congenital adrenal hyperplasia. Curr. Urol. Rep. 2001; 2: 11–18.Google Scholar
Hoepffner, W., Schulze, E., Bennek, J.et al. Pregnancies in patients with congenital adrenal hyperplasia with complete or almost complete impairment of 21-hydroxylase activity. Fertil. Steril. 2004; 81: 1314–21.Google Scholar
Krone, N., Wachter, I., Stefanidou, M.et al. Mothers with congenital adrenal hyperplasia and their children: outcome of pregnancy, birth and childhood. Clin. Endocrinol. 2001; 55: 523–9.Google Scholar
Picolos, M. K., Sims, C. R., Mastrobattista, J. M.et al. Milk-alkali syndrome in pregnancy. Obstet. Gynecol. 2004; 104: 1201–4.Google Scholar
Caplan, R. H., Miller, C. D. & Silva, P. D.Severe hypercalcemia in a lactating woman in association with moderate calcium carbonate supplementation: a case report. J. Reprod. Med. 2004; 49: 214–17.Google Scholar
Kort, K. C., Schiller, H. J. & Numann, P. J.Hyperparathyroidism and pregnancy. Am. J. Surg. 1999; 177: 66–8.Google Scholar
Iqbal, N., Steinberg, H., Aldasouqi, S. & Edmondson, J. W.Nephrolithiasis during pregnancy secondary to primary hyperparathyroidism. Urology 2001; 57: 554.Google Scholar
Dahan, M. & Chang, R. J.Pancreatitis secondary to hyperparathyroidism during pregnancy. Obstet. Gynecol. 2001; 98: 923–5.Google Scholar
Jaafar, R., Yun Boo, N., Rasat, R. & Latiff, H. A.Neonatal seizures due to maternal primary hyperparathyroidism. J. Paediatr. Child Health 2004; 40: 329.Google Scholar
Schnatz, P. F.Surgical treatment of primary hyperparathyroidism during the third trimester. Obstet. Gynecol. 2002; 99: 961–3.Google Scholar
Tollin, S. R.Course and outcome of pregnancy in a patient with mild, asymptomatic, primary hyperparathyroidism diagnosed before conception. Am. J. Med. Sci. 2000; 320: 144–7.Google Scholar
Schnatz, P. F. & Curry, S. L.Primary hyperparathyroidism in pregnancy: evidence-based management. Obstet. Gynecol. Surv. 2002; 57: 365–76.Google Scholar
Negishi, H., Kobayashi, M., Nishida, R.et al. Primary hyperparathyroidism and simultaneous bilateral fracture of the femoral neck during pregnancy. J. Trauma 2002; 52: 367–9.Google Scholar
Callies, F., Arlt, W., Scholz, H. J.et al. Management of hypoparathyroidism during pregnancy – report of twelve cases. Eur. J. Endocrinol. 1998; 139: 284–9.Google Scholar
Mather, K. J., Chik, C. L. & Corenblum, B.Maintenance of serum calcium by parathyroid hormone-related peptide during lactation in a hypoparathyroid patient. J. Clin. Endocrinol. Metab. 1999; 84: 424–7.Google Scholar

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  • Rare endocrine disorders
    • By J. M. Mhyre, Robert Wood Johnson Clinical Scholar, Lecturer, Department of Anesthesiology, Division of Obstetrical Anesthesiology, L. S. Polley, Associate Professor of Anesthesiology, Director, Obstetric Anesthesiology, University of Michigan, Health System F3900, Mott Children's Hospital, Ann Arbor, MI, USA
  • Edited by David R. Gambling, University of California, San Diego, M. Joanne Douglas, University of British Columbia, Vancouver, Robert S. F. McKay, University of Kansas
  • Book: Obstetric Anesthesia and Uncommon Disorders
  • Online publication: 19 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544552.017
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  • Rare endocrine disorders
    • By J. M. Mhyre, Robert Wood Johnson Clinical Scholar, Lecturer, Department of Anesthesiology, Division of Obstetrical Anesthesiology, L. S. Polley, Associate Professor of Anesthesiology, Director, Obstetric Anesthesiology, University of Michigan, Health System F3900, Mott Children's Hospital, Ann Arbor, MI, USA
  • Edited by David R. Gambling, University of California, San Diego, M. Joanne Douglas, University of British Columbia, Vancouver, Robert S. F. McKay, University of Kansas
  • Book: Obstetric Anesthesia and Uncommon Disorders
  • Online publication: 19 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544552.017
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Rare endocrine disorders
    • By J. M. Mhyre, Robert Wood Johnson Clinical Scholar, Lecturer, Department of Anesthesiology, Division of Obstetrical Anesthesiology, L. S. Polley, Associate Professor of Anesthesiology, Director, Obstetric Anesthesiology, University of Michigan, Health System F3900, Mott Children's Hospital, Ann Arbor, MI, USA
  • Edited by David R. Gambling, University of California, San Diego, M. Joanne Douglas, University of British Columbia, Vancouver, Robert S. F. McKay, University of Kansas
  • Book: Obstetric Anesthesia and Uncommon Disorders
  • Online publication: 19 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544552.017
Available formats
×