Nelson syndrome and perinatal challenges: A case report and systematic review of the literature.
Cushing syndrome
Nelson syndrome
Nelson syndrome in pregnancy
bilateral adrenalectomy
Journal
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
ISSN: 1879-3479
Titre abrégé: Int J Gynaecol Obstet
Pays: United States
ID NLM: 0210174
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
received:
14
02
2023
accepted:
29
03
2023
medline:
18
9
2023
pubmed:
2
5
2023
entrez:
2
5
2023
Statut:
ppublish
Résumé
Nelson syndrome is a rare and potentially life-threatening complication of treatment with total bilateral adrenalectomy for women with Cushing disease. A successful term pregnancy following fertility treatment in a patient with Nelson syndrome is presented. Our study provides guidance in the prenatal and intrapartum management of this condition. A case report and a systematic review of 14 papers describing 50 pregnancies are presented. An electronic database search included Medline (1946 to September 2022), Embase (1980 to September 2022), Cochrane Library, and UKOSS. A small number of pregnancies in women with Nelson syndrome are reported in literature, but there are no guidelines. Some authors detail the prenatal care provided to their patients. Four studies report prenatal monitoring with visual field checks and two report monitoring with X-rays. Five studies report the use of parenteral hydrocortisone at the time of delivery. Where described, women delivered appropriately grown newborns at term, with timing and mode of delivery dictated by obstetric indications. Preconception counseling and optimization of maternal health status improve pregnancy outcomes in women with Nelson syndrome. Multidisciplinary review in a combined obstetric-endocrine prenatal clinic is ideal. Awareness about potential complications during pregnancy and the postnatal period is crucial in providing optimal care to the mother and baby.
Types de publication
Systematic Review
Case Reports
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
89-95Informations de copyright
© 2023 International Federation of Gynecology and Obstetrics.
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