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30 - Endocrineemergencies in pregnancy

from Section 5 - Medical and Surgical Emergencies during Pregnancy

Published online by Cambridge University Press:  05 November 2012

By
Manilka Sumanatilleke
Edited by
Edwin Chandraharan  and
Sabaratnam Arulkumaran
Edwin Chandraharan
Affiliation:
St George’s University of London
Sabaratnam Arulkumaran
Affiliation:
St George’s University of London
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Summary

A number of endocrine diseases and emergencies can have unique characteristics in pregnancy and many early symptoms of common endocrine conditions may be difficult to differentiate from common symptoms experienced during a normal pregnant state. Thyroid storm is a clinical and biochemical state resulting in acute, severe over-production of and exposure to thyroid hormones. Glucocorticoids, iodides and beta-blockers are used in clinical management of thyroid storm. Myxoedema coma can occur in a woman with previously undiagnosed mild to moderate hypothyroidism progressing rapidly due to precipitating factor. Acute adrenal insufficiency caused by autoimmune destruction of adrenal cortex is managed by hydrocortisone treatment. Phaeochromocytoma crisis has highest risk of hypertensive crisis and death during labour. Alpha blockade with phenoxybenzamine is administered intravenously or orally according to the clinical status. Pituitary apoplexy, lymphocytic hypophysitis, pre-existing hypopituitarism are disorders of pitutary gland. Apoplexy needs careful monitoring of visual acuity and other upper cranial nerves.
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Chapter
Information
Obstetric and Intrapartum Emergencies
A Practical Guide to Management
 , pp. 204 - 213
Publisher: Cambridge University Press
Print publication year: 2012

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