Endocrine Abstracts

Introduction: Cushing’s syndrome usually causes hypogonadism. Occurrence of pregnancy in this context is rare, and is associated with significant morbidity and perinatal mortality. We report two cases of pregnancies in two patients with Cushing’s disease.

Case 1: Our first Patient was 37-year-old who presented during the second trimester of pregnancy a Cushing syndrome. The positive diagnosis was made regadless clinical signs and a hight free urinary cortisol at 4839 nmol / L, ACTH was normal at 4.4 pmol. The retaining etiology was a macroadenoma mesured 17×11×10 mm lowering the sellar floor and opto-chiasmatic tanks with visual field impairment: presence of central scotomas and devices. Treatment consisted of a transsphenoidal resection at 13 weeks of prangnancy. Evolution was marked by the occurrence of spontaneous abortion 16 days postoperatively.

Case 2: Our second patient was 35-year-old and operated for Cushing’s disease with recurrence of her illness. The indication of revision surgery for a microadenoma was made after medical preparation by ketoconazole which was interrompted at the discovery of a 6 weeks pregnancy. In the absence of clinical and biological signs of disease activity revision surgery was scheduled after childbirth. Pregnancy was achived without maternal or fetal complications.

Discussion: Cushing’s disease and pregnancy is a rare combination and it can causes a therapeutic management problem with a high risk of maternal and fetal complications.