Evidence map›Paper›PMID 33779937›Full record

SynthesisPituitary2021

Diagnosis and treatment outcomes of Cushing's disease during pregnancy.

Kalyani Sridharan, Jayaprakash Sahoo, Rajan Palui, Milind Patil, Sadishkumar Kamalanathan, A S Ramesh, N S Kubera

Abstract readCase ReportsSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Pituitary, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.3field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 14 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Kalyani SridharanDepartment of Endocrinology and Metabolism, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India. sridharan.kalyani22@gmail.com.ORCID http://orcid.org/0000-0002-5867-5073
Jayaprakash SahooDepartment of Endocrinology and Metabolism, Jawaharlal Institute of Post Graduate Medical Education and Research, Dhanvanthri Nagar, Puducherry, India.
Rajan PaluiConsultant Endocrinologist, The Mission Hospital, Durgapur, West Bengal, India.ORCID http://orcid.org/0000-0002-2429-3595
Milind PatilConsultant Endocrinologist, Inlaks Budhrani Hospital, Pune, India.ORCID http://orcid.org/0000-0002-8932-6810
Sadishkumar KamalanathanDepartment of Endocrinology and Metabolism, Jawaharlal Institute of Post Graduate Medical Education and Research, Dhanvanthri Nagar, Puducherry, India.ORCID http://orcid.org/0000-0002-2371-0625
A S RameshDepartment of Neurosurgery, Jawaharlal Institute of Post Graduate Medical Education and Research, Dhanvanthri Nagar, Puducherry, India.
N S KuberaDepartment of Obstetrics and Gynecology, Jawaharlal Institute of Post Graduate Medical Education and Research, Dhanvanthri Nagar, Puducherry, India.
Jawaharlal Institute of Post Graduate Medical Education and Research · INAll India Institute of Medical Sciences Rishikesh · INInlaks & Budhrani Hospital · INMission Hospital Durgapur · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeWe report a case of a pregnant woman with Cushing's disease (CD) and performed a systematic review of literature on diagnosis, treatment, maternal and fetal outcomes of CD in pregnancy.

methodsA PubMed search was performed for manuscripts in English language from inception till June 2020. Cases of CD with hypercortisolism during pregnancy were included and categorized into three groups based on treatment received. Data on diagnostic modalities, CD remission, materno-fetal outcomes were analysed.

resultsFifty-five patients of CD with 62 pregnancies were analysed. 24-h urinary free cortisol(UFC) was elevated by a mean of 5.4 ± 4.2 fold upper limit of normal non-pregnant level. 12/19 (63.1%) CD patients had more than threefold elevation of UFC measured during pregnancy. Mean midnight serum cortisol was 753.7 ± 270.5 nmol/l. At a midnight serum cortisol cut off of 440 nmol/l, 15/16 patients were correctly identified as CD. 23.2% underwent trans-sphenoidal surgery (group 1), 16.1% received only medical treatment (group 2) while 60.7% received no treatment (group 3) during pregnancy. Remission rates for CD in groups 1 and 2 were 76.9% and 77.8%, respectively. Adverse maternal and fetal outcomes were seen in 53.9% and 59.3% of the patients, respectively and were not significantly different between groups, although, lesser live births and greater pregnancy losses were seen in group 3.

conclusionMidnight serum cortisol had better sensitivity than UFC for diagnosing hypercortisolism due to CD during pregnancy. In general, CD should be treated during pregnancy in order to optimize maternal and fetal outcomes as a trend towards increased live births is seen in treated subjects.

Indexed as

Pituitary ACTH HypersecretionFemaleHumansHydrocortisonePregnancyTreatment OutcomeHydrocortisoneCushing’s diseaseCushing’s syndromePregnancyTrans-sphenoidal surgery

Identifiers

PMID33779937
OpenAlexW3143538566

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.