ABSTRACT
While Cushing’s disease due to a pituitary adenoma is the most common cause of hypercortisolism in the general population, Cushing’s syndrome in pregnancy is usually due to an adrenal adenoma. Pregnancy is normally a state of physiologic hypercortisolism, thus the diagnosis of Cushing’s syndrome in pregnancy can be challenging. Diagnostic testing usually consists of a urine free or midnight salivary cortisol >3 times the upper limit of normal with measurement of ACTH to determine ACTH-dependent or independent disease. Surgical resection in the second trimester is the preferred treatment.
