Glucocorticoid therapy for nonclassic congenital adrenal hyperplasia in women


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Objective. To analyze the impact of glucocorticoid (GC) therapy on the reproductive system, the course of pregnancy and labor, fetal development in patients with nonclassic congenital adrenal hyperplasia (NCCAH). Subject and methods. Reproductive system diseases and hormonal status were investigated in 46 women with NCCAH. All the women were treated with GC. Jointly with gynecologists, the investigators monitored the course of pregnancy and labor and fetal status in 43 women during prednisolone therapy. Results. The patients with NCCAH were observed to have reproductive system diseases caused by hypersecretion of the adrenal androgen 17α-OH progesterone (17 OH-n). GC treatment restored fertility. Conclusion. Adrenal androgen hypersecretion in patients with NCCAH gives rise to reproductive disorders and infertility. It is necessary to initiate suppressive (and replacement) therapy with GC and to normalize blood 17-OH-n levels in such patients in adolescence. Prednisolone therapy is certain to be performed in pregnancy to prevent miscarriage. In this case, prednisolone has no effect on fetal development.

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作者简介

Irina Tereshchenko

Academician E.A. Vagner Perm State Medical University, Ministry of Health of Russia

Email: i_v_t@bk.ru
MD, professor of endocrinology and clinical pharmacology

参考

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