Gynecologic implications of the adrenogenital syndrome in adolescent and adult women

Objective: The adrenogenital syndrome (AGS) is familiar to pediatricians bu t less so to gynecologists. The aim of this study was to evaluate the gynec ologic history and status of adult females with ACS. Methods: We attempted to contact 100 patients with AGS treated at our insti tution between 1958 and 1996. Forty-five patients completed a questionnaire ; 21 additionally underwent a gynecologic examination. Results: Fifteen patients had the salt-wasting form, 26 the simple virilizi ng form, and 4 the late-onset form of AGS. The mean age of menarche was 14. 8, 13.9, and 16.5 years, respectively. Before reconstructive surgery, genit alia had been Prader intersexual stage I in 8, stage II in 10, stage IV in 14, and stage V in 2 patients. Menstrual irregularities were reported by 75 % and urologic problems by 33% of the women. Thirty-three patients (73%) we re sexually active. Sixteen patients became pregnant and those with the sim ple virilizing or late-onset form of the condition delivered a total of 26 children (13 vaginal, 2 forceps, and 11 cesarean deliveries). Conclusions: These data confirm the long-term concerns associated with AGS. However, pregnancy and vaginal delivery are feasible in many of these wome n despite previous genital surgery.