Pregnancy outcomes in women with congenital virilizing adrenal hyperplasia

Low fertility rates have traditionally been reported among women with viril izing CAH, especially among those with the salt-wasting variant of this dis order. Pregnancy experience in this population remains limited; however, re cent data suggest that fertility rates are significantly improved because o f earlier treatment, advances in surgical reconstruction, and improved comp liance with therapy. This article reviews the reported pregnancy outcomes i n women with CAH and discusses the importance of careful endocrine monitori ng during gestation. Placental aromatase activity is the principal mechanis m that protects the female fetus from the virilizing effects of maternal hy perandrogenism. issues concerning preconception counseling and specific gui delines for the management of pregnancy and delivery in these women are als o discussed.