A successful pregnancy in a Turner syndrome with oocyte donation

Nwosu, E. C.; Brockbank, Anna; Walkinshaw, S.

doi:10.3109/01443615.2012.676695

Cited by 7 publications

(3 citation statements)

References 31 publications

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“…This case, along with several recently published papers 4,15 demonstrates that favourable maternal and fetal outcomes are achievable in pregnant women with Turner's syndrome despite the significant risks posed by their associated medical conditions. Detailed pre-pregnancy counselling and cardiovascular assessment are vital, in addition to individualised, intensive multidisciplinary antenatal monitoring and delivery planning.…”

Section: Resultsmentioning

confidence: 99%

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Successful pregnancy outcome in a woman with Turner’s syndrome

et al. 2014

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Women with Turner's syndrome have a high incidence of cardiovascular complications, endocrine and hypertensive disorders. Those with the 45X chromosome complement require oocyte donation and in vitro fertilisation to conceive. Pregnancies in such women are challenging to manage due to the high risk of pregnancy-related hypertensive disorders, impaired glucose tolerance, fetal growth restriction and preterm birth. Women also need to be aware of the significant risk of aortic dilatation, dissection or rupture in pregnancy, which may be fatal. Despite these risks, favourable obstetric outcomes are achievable with careful pre-pregnancy counselling and cardiovascular assessment, intensive multidisciplinary antenatal monitoring and individualised delivery planning. We report the case of a 33-year-old woman with Turner's syndrome, pre-existing hypertension, insulin-dependent diabetes and primary hypoparathyroidism who had a successful pregnancy with good maternal and fetal outcomes despite the complexity of her medical conditions. Keywords High-risk pregnancy, diabetes, hypertension, infertility, Turner's syndrome Case reportA 33-year-old woman diagnosed with Turner's syndrome in childhood became pregnant after five cycles of in vitro fertilisation (IVF) with donor oocytes. She suffered from recurrent ear infections as a child, necessitating an adenoidectomy and myringotomy aged four. Karyotyping performed at the age of 10 due to short stature (126 cm) revealed monosomy 45X. She received growth hormone until the age of 16 to induce adult height. Oestradiol was commenced at age 13 to stimulate puberty, then switched to combined sequential hormone replacement therapy to protect the endometrium and induce progesterone withdrawal bleeds. Cardiac imaging revealed a small subaortic membrane with no significant gradient across the left ventricular outflow tract (peak of 12 mmHg only), good left ventricular function and no coarctation or dilatation of the aorta. She attended for annual echocardiogram and cardiology review and remained asymptomatic. She was admitted to hospital with persistent vomiting aged 22, found to be in diabetic ketoacidosis and diagnosed with type 1 diabetes. At the age of 27, she developed hypertension which was treated with lisinopril. She attended for pre-pregnancy counselling aged 28. Her height was 153 cm, weight 62 kg and BMI 26. Her antihypertensive medication was changed to methyldopa, as angiotensin-converting enzyme inhibitors are contraindicated in pregnancy. She commenced folic acid 5 mg daily. With the support of the diabetes team over the next four years, she reduced her HbA1c from 8.4% to obtain optimal glycaemic control with a continuous subcutaneous insulin pump. She also underwent laser treatment for diabetic retinopathy.Her fifth IVF cycle was successful and supported by oestradiol, progesterone, prednisolone, aspirin and low-molecular-weight heparin (LMWH). She received intralipid infusions on days 4-9 of her IVF treatment protocol in a research context, as investigations for ...

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Section: Resultsmentioning

confidence: 99%

“…3,4,11,14 However, one recent case report describes a woman with no associated medical conditions, who did not develop any obstetric complications and had an instrumental delivery of an appropriately grown baby at term. 15 …”

Section: Discussionmentioning

confidence: 99%

Successful pregnancy outcome in a woman with Turner’s syndrome

et al. 2014

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“…GH therapy should generally begin as soon as growth failure occurs, allowing for the rapid normalization of height. Advanced assisted reproductive technology (ART) may help some patients with TS to achieve pregnancies [19,20].…”

Section: Discussionmentioning

confidence: 99%

Pseudohypoparathyroidism with Hashimoto’s thyroiditis and Turner syndrome: a case report

Zeng

Jia

et al. 2014

Gynecological Endocrinology

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Cardiovascular risk in Turner syndrome

Donato

Ferreira

2018

Revista Portuguesa de Cardiologia

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Turner syndrome is a relatively common genetic disorder of female development, characterized by partial or complete absence of an X chromosome, with a variable clinical presentation. Congenital or acquired cardiovascular disease is highly prevalent and a major cause of early death in this syndrome. The most feared complication is aortic dissection, which can occur at a very young age and requires careful assessment of its risk factors. A systematic literature search identified sixty relevant publications. These were reviewed with regard to the increased risk of cardiovascular disease in women with Turner syndrome, especially in pregnancy. The most common congenital cardiovascular defects are presented and illustrated with appropriate iconography. The current recommendations regarding the screening and monitoring of cardiovascular disease in these patients are discussed.

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A successful pregnancy in a Turner syndrome with oocyte donation

Cited by 7 publications

References 31 publications

Successful pregnancy outcome in a woman with Turner’s syndrome

Successful pregnancy outcome in a woman with Turner’s syndrome

Pseudohypoparathyroidism with Hashimoto’s thyroiditis and Turner syndrome: a case report

Cardiovascular risk in Turner syndrome

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