According to a new study, pregnant women with high levels of cortisol and high blood pressure may have Cushing’s disease. Although Cushing’s is rare during a woman’s pregnancy, the conclusion of this study would have health care providers of various disciplines working together to identify such an issue during pregnancy. You can read more about this story here.
The study, which was published in an Iranian medial journal, described the case of a 29-year old woman, who was in her final trimester of pregnancy. The woman was admitted with high blood pressure, swollen limbs, and general weakness. Her blood levels of cortisol were high, but that is common in pregnancy.
Cushing’s disease results when a person’s adrenal glands over produce the hormone cortisol. Cortisol is an important hormone that helps people respond to stressful situations. The use of steroids is the most common contributor to Cushing’s disease. Any time the body over produces cortisol it is called Cushing’s disease, no matter the reason why. Many patients who have Cushing’s disease have a tumor in their adrenal gland that causes the over production of cortisol, but in others Cushing’s is cause by the pituitary gland producing too much of the hormone ACTH, which in turn causes the adrenal glands to over produce cortisol.
“Cushing’s syndrome should be considered in hypertensive pregnant patients with remarkable signs of hypercortisolism,”
— study researchers
Treatment for Cushing’s disease usually involves surgical removal of the pituitary or adrenal glands, depending on where the disease is originating. In the case of the 29-year old woman in the Iranian Journal of Medical Sciences study, the woman gave birth and a week later, her adrenal gland with a tumor was removed. Her cortisol levels and blood pressure normalized.
It’s important to recognize that, although Cushing’s disease is rare in pregnant women, the consequences of missing a diagnosis in these cases can lead to premature births and an increase in infant mortality. In order to avoid any mistakes, all members of the health care team need to work collaboratively, including physician specialists such as obstetrics, endocrinologists, and surgeons.