Adrenal Crisis During Cesarean Section in a Patient With Primary Adrenal Insufficiency

Pestana, Inês; Guimarães, Henrique; Saraiva, Alexandra; Veiga, Dalila; Machado, Humberto

http://hdl.handle.net/10400.16/2968

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Abstract(s)

Congenital adrenal hyperplasia (CAH) is a type of primary adrenal insufficiency (AI) that predisposes to adrenal crisis (AC) during stress. We describe a case of a primipara with CAH who was admitted in labor. To prevent AC, glucocorticoid replacement was given according to guidelines. Due to fetal decelerations, an emergency C-section was performed under general anesthesia following which refractory hypotension emerged. The diagnosis of AC was considered, and hydrocortisone was given with sustained hemodynamic improvement. AC is a life-threatening emergency whose diagnosis requires a high index of suspicion. Despite adequate steroid coverage, additional stressors may precipitate AC, so it is of paramount importance that anesthesiologists consider this emergency

Keywords

adrenal crisis cardiovascular collapse congenital adrenal hyperplasia life-threatening emergency obstetric anesthesia primary adrenal insufficiency

URI

http://hdl.handle.net/10400.16/2968

Citation

Pestana I, Guimarães H, Saraiva A, Veiga D, Machado H. Adrenal Crisis During Cesarean Section in a Patient With Primary Adrenal Insufficiency. Cureus. 2023;15(12):e49964. Published 2023 Dec 5. doi:10.7759/cureus.49964Pestana I, Guimarães H, Saraiva A, Veiga D, Machado H. Adrenal Crisis During Cesarean Section in a Patient With Primary Adrenal Insufficiency. Cureus. 2023;15(12):e49964.doi:10.7759/cureus.49964