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Adrenal insufficiency in pregnancy — SCE Endocrinology MCQ

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ModerateEndocrinology in pregnancyAdrenal insufficiency in pregnancySCE Endocrinology

A 34-year-old woman with known Addison's disease is 16 weeks pregnant. She is well on hydrocortisone and fludrocortisone and asks about delivery planning. What is the most appropriate advice?

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Correct answer: A — Plan stress-dose hydrocortisone during labour and delivery

Pregnancy and delivery require anticipatory adrenal crisis planning, including stress-dose hydrocortisone for labour. Stopping replacement is dangerous. Dexamethasone crosses the placenta and is not routine maternal replacement.

Reference: Society for Endocrinology Adrenal Insufficiency Guidance; NICE NG243