Glucocorticosteroid therapy in patients with adrenal form of hyperandrogenism during pregnancy.

Safaryan Irma Romanovna, Manukhin Igor Borisovich, Gevorkyan Marianna Aramovna, Manukhina Ekaterina Igorevna, Ovakimyan Marlen Arturovich

Backgraund: hyperandrogenism or excess androgens is the most common endocrine pathology of the reproductive system, which affects about 5-10% of women in the population. Correction of hyperandrogenism during pregnancy remains an actual aspect of modern medicine. The use of glucocorticosteroids in pregnancy is still controversial. It should be noted that with a deficiency of C21-hydroxylase, the appointment of glucocorticosteroids is pathogenetically justified. Objective: to identify risk factors for complications of gestation in patients with adrenal GA and normal body weight, to justify the appointment of glucocorticoid therapy to patients with NK-VDKN, to determine the indications for increasing the dose. Materials and methods: The study group included 25 pregnant women with non-classical form of congenital adrenal cortex dysfunction, whose diagnosis was confirmed before pregnancy. The appointment of metipred to patients was carried out under the control of the level of 17-OnP, at a selected dose not exceeding 0.5 mg until 14-16 weeks of pregnancy, i.e. before the time of placenta formation. Results: Glucocorticosteroid therapy was carried out in 25 patients under the control of 17-OnP level and was carried out up to 14-16 weeks of pregnancy. The threat of termination of pregnancy before 12 weeks of pregnancy was observed in 24% (n=6) patients. A correlation was obtained between the level of 17-OnP and signs of threatened abortion. Thus, the level of 17-OHP≥5,6 ng / ml indicates the need for correction of the dose of glucocorticoids. During treatment, there was a decrease in the threat of abortion in the first trimester. Conclusions: The administration of glucocorticoid therapy to patients with NK-VDKN is pathogenetically justified. Timely detection of NK-VDKN during pregnancy planning allows timely initiation of pathogenetic therapy and reduction of perinatal risks.

Keywords:adrenal hyperandrogenism, hormonal therapy, corticosteroids, the risk of miscarriage, androgens