THE OCCURRENCE OF PRE-ECLAMPSIA IN A BILATERALLY ADRENALECTOMIZED WOMAN*

Abstract

A case is reported of pre-eclampsia developing during the eighth month of pregnancy in a woman who had undergone total bilateral adrenalectomy because of Cushing''s syndrome. During the time that she had pre-eclampsia (as manifested by hypertension, edema, albuminuria and an elevated concentration of serum uric acid and confirmed by functional and anatomic changes in the placenta) the levels of plasma and urinary 17-hydroxycorticosteroids were low. At the same time the urinary excretion of aldosterone, also low, was comparable to that reported for normal pregnancies in adrenalectomized women. Hypertension persisted in spite of withdrawal of adrenal steroid therapy and the development of adrenal insufficiency. These events cast doubt on the etiologic role of the adrenal steroids in toxemia of pregnancy.