How is adrenal insufficiency (AI) (Addison disease) treated during pregnancy?

Updated: Dec 03, 2020
  • Author: Kimberly Tafuri, DO; Chief Editor: Sasigarn A Bowden, MD  more...
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Preferred glucocorticoids during pregnancy are hydrocortisone or prednisone, because the placenta inactivates them and thereby prevents exposing the fetus to excess glucocorticoids. Therefore, dosage requirements may increase during pregnancy.

In contrast, dexamethasone and betamethasone readily cross the placenta and can suppress fetal adrenal function.

Because cortisol from the adrenal cortex stimulates phenylethanolamine N -methyltransferase, the last step in epinephrine synthesis, in the adrenal medulla, patients with cortisol deficiency have deficient epinephrine responses to stress, a condition not amenable to replacement therapy. [62, 63]

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