MedElevator
Войти в исследования Current Management and Outcome of Pregnancies in Women With Adrenal Insufficiency: Experience from a Multicenter Survey.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Bothou Christina, Anand Gurpreet, Li Dingfeng, Kienitz Tina, Seejore Khyatisha, Simeoli Chiara, Ebbehoj Andreas, Ward Emma G, Paragliola Rosa Maria, Ferrigno Rosario, Badenhoop Klaus, Bensing Sophie, Oksnes Marianne, Esposito Daniela, Bergthorsdottir Ragnhildur, Drake William, Wahlberg Jeanette, Reisch Nicole, Hahner Stefanie, Pearce Simon, Trainer Peter, Etzrodt-Walter Gwendolin, Thalmann Sébastien P, Sævik Åse B, Husebye Eystein, Isidori Andrea M, Falhammar Henrik, Meyer Gesine, Corsello Salvatore M, Pivonello Rosario, Murray Robert, Bancos Irina, Quinkler Marcus, Beuschlein Felix
Аннотация
OBJECTIVE: Multicenter survey on current clinical approaches in managing AI during pregnancy.
DESIGN: Retrospective anonymized data collection from 19 international centers from 2013 to 2019.
SETTING AND PATIENTS: 128 pregnancies in 113 women with different causes of AI: Addison disease (44%), secondary AI (25%), congenital adrenal hyperplasia (25%), and acquired AI due to bilateral adrenalectomy (6%).
RESULTS: Hydrocortisone (HC) was the most commonly used glucocorticoid in 83% (97/117) of pregnancies. Glucocorticoid dosage was increased at any time during pregnancy in 73/128 (57%) of cases. In these cases, the difference in the daily dose of HC equivalent between baseline and the third trimester was 8.6 ± 5.4 (range 1-30) mg. Fludrocortisone dosage was increased in fewer cases (7/54 during the first trimester, 9/64 during the second trimester, and 9/62 cases during the third trimester). Overall, an adrenal crisis was reported in 9/128 (7%) pregnancies. Cesarean section was the most frequent mode of delivery at 58% (69/118). Fetal complications were reported in 3/120 (3%) and minor maternal complications in 15/120 (13%) pregnancies without fatal outcomes.
CONCLUSIONS: This survey confirms good maternal and fetal outcome in women with AI managed in specialized endocrine centers. An emphasis on careful endocrine follow-up and repeated patient education is likely to have reduced the risk of adrenal crisis and resulted in positive outcomes.