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RCOG World Congress 2025
June 23 - 25, 2025 | ExCeL London, UK
EP.1660
Managing Congenital Adrenal Hyperplasia and Complex Comorbidities in Pregnancy: A Multidisciplinary Approach.
Poster Presenter
Authors
Affiliations
Part of Topic
Maternal medicine
Managing Congenital Adrenal Hyperplasia and Complex Comorbidities in Pregnancy: A Multidisciplinary Approach.
Samir Imam1, Wiaam Elradi1
1 Obstetrics and Gynaecology Department, The James Cook University Hospital, South Tees NHS Foundation Trust, Middlesbrough, United Kingdom.
Background
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Congenital Adrenal Hyperplasia (CAH) is a rareendocrine disorder that complicates pregnancymanagement.
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This case involves CAH alongsidehypothyroidism, gestational diabetes mellitus(GDM), and epilepsy, requiring robustinterdisciplinary coordinatiion.
Case Summary
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A 31-year-old woman with a known history ofclassical CAH since childhood, hypothyroidism,and focal epilepsy was referred to the high-riskantenatal clinic. She had been on lifelongglucocorticoid therapy (Hydrocortisone 10 mg AM /Prednisolone 2.5 mg PM) and Levothyroxine forhypothyroidism.
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Preconception planning:
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Reviewed by endocrinology and fertility teams
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Genetic counselling: partner not a carrier for CAHmutations
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Pregnancy course:
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Hydrocortisone and prednisolone increased tomeet gestational cortisol demands
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Levetiracetam introduced at 250 mg BD →increased to 500 mg BD
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Levothyroxine increased to 100 mcg daily
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GDM diagnosed in the third trimester via homeglucose monitoring (OGTT negative earlier)
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Glycaemic control achieved with dietarymodifications and insulin