ENDOCRINE DISEASES

Pregnancy is characterized by profound endocrine adaptations that affect the thyroid, parathyroid, pituitary, and adrenal glands, with significant implications for both maternal and fetal health. This chapter provides a comprehensive overview of the physiological changes in endocrine systems during gestation and their clinical relevance, alongside a detailed discussion of the diagnosis and management of common and rare endocrine disorders in pregnancy. Thyroid diseases, including hyperthyroidism, hypothyroidism, and gestational thyroid dysfunction, represent the most frequent endocrine problems, with maternal thyroid hormone levels playing a critical role in fetal neurodevelopment. Disorders of the parathyroid gland, such as hyperparathyroidism and hypoparathyroidism, though rare, may lead to maternal complications and adverse neonatal outcomes, necessitating individualized management strategies. Pituitary disorders, including prolactinomas, acromegaly, hypopituitarism, and gestational diabetes insipidus, pose diagnostic and therapeutic challenges due to overlapping physiological chang-es of pregnancy. Similarly, adrenal diseases such as Cushing’s syndrome, Addison’s disease, and pheo-chromocytoma, although uncommon, are associated with high maternal and perinatal morbidity and mortality when unrecognized or inadequately treated. In each condition, timely diagnosis and tailored management based on current guidelines are essential to reduce risks such as miscarriage, preterm birth, fetal growth restriction, hypertensive disorders, and long-term neurocognitive impairments in offspring. The chapter also highlights the importance of multidisciplinary collaboration between ob-stetricians, endocrinologists, and neonatologists to ensure optimal outcomes. By integrating updated recommendations and emphasizing both maternal safety and fetal well-being, this work provides a practical clinical guide for managing endocrine diseases in pregnancy.