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Congenital adrenal hyperplasia in pregnancy — SCE Endocrinology MCQ

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ModerateAdrenalCongenital adrenal hyperplasia in pregnancySCE Endocrinology

A 29-year-old woman has adrenal insufficiency due to congenital adrenal hyperplasia. She is planning pregnancy and is taking dexamethasone at night. Blood pressure and glucose are normal. What is the most appropriate medication review?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Switch to hydrocortisone or prednisolone before pregnancy where appropriate

Dexamethasone crosses the placenta and is not the routine replacement glucocorticoid in pregnancy planning. Hydrocortisone or prednisolone is generally preferred for maternal replacement. Stopping glucocorticoids risks adrenal crisis and androgen excess.

Reference: Endocrine Society CAH Guideline; BNF