PRENATAL TREATMENT OF CONGENITAL ADRENAL- HYPERPLASIA DUE TO 21-HYDROXYLASE DEFICIENCY - A REVIEW OF 9 CASES

Prenatal treatment based on administration of dexamethasone to the mot her during pregnancy was initiated early during nine pregnancies with a high risk of congenital adrenal hyperplasia due to 2 1 -hydroxylase deficiency. The purpose of this treatment was to prevent fetal viriliz ation by reducing production of androgens by the adrenal glands. Prena tal diagnosis was achieved by comparing amniotic fluid cell HLA genoty pes and more recently by subjecting trophoblasts to molecular genetic studies. Together with prenatal determination of fetal sex, this allow ed to determine that only two female fetuses were affected. Efficacy o f continued prenatal treatment in these two cases was good in one case and mediocre in the other. The treatment was well tolerated by the mo thers and fetuses.