Frontiers in Medicine (Sep 2022)

Adrenal crisis during pregnancy: Case report and obstetric perspective

  • Barbara Gardella,
  • Barbara Gardella,
  • Andrea Gritti,
  • Andrea Gritti,
  • Annachiara Licia Scatigno,
  • Annachiara Licia Scatigno,
  • Anna Maria Clelia Gallotti,
  • Francesca Perotti,
  • Francesca Perotti,
  • Mattia Dominoni,
  • Mattia Dominoni

DOI
https://doi.org/10.3389/fmed.2022.891101
Journal volume & issue
Vol. 9

Abstract

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Adrenal dysfunction (AD) and, in particular, adrenal crisis are uncommon events in pregnant women, but associated with significant maternal and fetal morbidity and mortality if untreated or undiagnosed. Adrenal crisis may be confused with the common symptoms of pregnancy: the obstetricians should be able to promptly diagnose and treat it in order to avoid the adverse outcomes regarding the mother and the fetus. For this reason, AD must be treated by an expert multidisciplinary team. We presented a case report of a young pregnant woman with adrenal crisis due to tuberculosis, cocaine abuse, and massive bilateral hemorrhage with symptoms of emesis, hypotension, sudden abdominal pain, and leukocytosis. The most common issues of diagnosis and treatment are discussed and analyzed. Finally, we performed a review of the literature regarding adrenal crisis and adrenal insufficiency (AI) in pregnancy in order to clarify the management of these diseases in obstetrics setting.

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