Pestana, InêsGuimarães, HenriqueSaraiva, AlexandraVeiga, DalilaMachado, Humberto2024-06-182024-06-182023-12Pestana 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.499642168-8184http://hdl.handle.net/10400.16/2968Congenital 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 emergencyengadrenal crisiscardiovascular collapsecongenital adrenal hyperplasialife-threatening emergencyobstetric anesthesiaprimary adrenal insufficiencyjournal article10.7759/cureus.49964