Fall 2005                                                     CARES Foundation, Inc.
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Pregnancy and CAH:  

What every woman with Classical CAH Should Know

 

by Ellen Seely, M.D.

Rhonda Bentley-Lewis, M.D., MBA

 

 

Can a woman with CAH become pregnant?

When should a woman with CAH seek help with family planning?

Once a woman with CAH decides she wants to conceive, she should seek out the supervision of a medical endocrinologist and an obstetrician who are experienced in the management of CAH during pregnancy.  The endocrinologist will help with regularization of the steroid dose to achieve optimal ovulation and then will work with the obstetrician during pregnancy on medication adjustment. Occasionally, an Ob-Gyn trained in reproductive endocrinology and infertility may need to help if pregnancy does not occur with regularization of menses. 

What is the chance of a woman with CAH having a child affected with CAH?

What are particular medical issues that have to be managed during pregnancy in a woman with CAH?

Are there any particular concerns a woman with CAH should have about labor and delivery?

Can women with CAH have healthy newborns?

Yes! Women with CAH can and do have healthy pregnancies and children. There are several reports of normal infants born to women with CAH.  Many endocrinologists who care for women with CAH take care of women who have had healthy pregnancies.  At the Endocrine and Hypertensive Disorders of Pregnancy Program at Brigham and Women’s Hospital, of the eight pregnancies we have taken care of, all have had healthy infants. In most states, neonates are screened for 21-hydroxylase deficiency automatically as part of the neonatal screen that takes place using blood obtained by a heel stick of the neonate. Screening for 21-hydroxylase deficiency is required to take place in 42 states as of August 12, 2005 (US National Newborn Screening Report).

Summary

 

 

Ellen Seely, M.D. is a  member of CARES’ Medical Advisory Board. She is the Director of Clinical Research in the Division of Endocrinology, Diabetes and Hypertension at the Brigham and Women’s Hospital in Boston and Associate Professor of Medicine at Harvard Medical School. 

 
       

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