High risk of congenital adrenal hyperplasia successful pregnancy one case and lierarure review
Department of Obsererics and Gynecology，Peking University Third Hospital， Beijing 100151，China The Fourth Hospital of Shijiazhuang，Shijiazhuang 050000，China
Abstract: ??Abstract??Objective To analyze the Perinatal Management of congenital adrenal hyperplasia with other complicating factors.Methods The couple in this case are both carriers of congenital adrenal hyperplasia,and underwent 3 adverse pregnancy. They had an infant died after birth relevant to the adrenal crisis. Second pregnancy stopped at 33 gestational weeks because of fetal death. A spontaneous abortion was the outcome of third pregnant experience. During the index pregnancy, given preconception councelling for patients at risk of having a child affected with CAH and prenatal diagnosis of detecting affected offspring by amniocentesis,including karyotype analysis and genetic diagnosis ,the gene mutation of fetus was uncertain.Taking into account the patient willness and the clinical need,except for the glucocorticoid medication,we focued on searching and monitoring the other fators which could be the main cause of the unexpected pregnancies.Resuts In our patient, after thinking over the inherited risk and side effects of glcocorticoid, the acquired thrombophilia was noticed and monitered. Without any glcocorticoid, successful pregnancy was achieved. Conclusion Historic recommendations have been to start empiric maternal glucocorticoid therapy in at-risk pregnancies until a diagnosis of fetal sex and enzyme status has been made.Exogenous steroid exposure in pregnancy is associated with negative effects for the fetus later in life and mothers. Accurate prenatal diagnosis thus becomes critical to avoid needless exposure??as well as the clinical monitoring. It is important that pregnant woman with congenital adrenal hyperplasia requires individualized management.
宋文惠 杨孜. 先天性肾上腺皮质增生高风险成功妊娠1例分析并文献复习[J]. 发育医学电子杂志, 2014, 2(2): 106-110.
SONG Wen-hui, YANG Zi. High risk of congenital adrenal hyperplasia successful pregnancy one case and lierarure review. Journal of Developmental Medicine(Electronic Version), 2014, 2(2): 106-110.
2014, Vol. 2 
