DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20161722

Successful pregnancy outcome in a case of Swyer Syndrome with hypertension and morbid obesity

Aradhana Kalra, Purnima K. Nadkarni, Pooja P. Singh, Aditi A. Nadkarni

Abstract


To report a case of Swyer syndrome with hypertension and morbid obesity with successful pregnancy and live birth after assisted reproductive technology. 27 year old morbidly obese female with essential hypertension who had been on HRT for 10 years with well-developed secondary sexual characters with primary infertility. After adequate development of the uterus and the endometrial preparation, Patients with Swyer syndrome conceive with oocyte donation and ICSI. Caesarean section rate is high due to multiple pregnancies and other obstetric complications. Early detection of these cases would help in timely development of their secondary sexual characters and restoration of menses and gonadectomy for prevention of malignancy as its propensity is high. Multidisciplinary approach is required including counseling and management of long term health problems. Pregnancy is feasible but caesarean rate is high.


Keywords


Gonadal dysgenesis, Multidisciplinary care, Gonadectomy, Oocyte donation

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References


Swyer GI. Male pseudo hermaphroditism: a hitherto undescribed form. Br Med J. 1955;2:709-12.

Lee AC, Fong CM. Ovarian choriocarcinoma as the first manifestation of 46, XY pure gonadal dysgenesis. J Pediatr Hematol Oncol. 2011;33:29-31.

Jager RJ, Anvret M, Hall K, Scherer G. A human XY female with a frameshift mutation in the candidate testis-determining gene SRY. Nature. 1990;348:452-4.

Michala L, Goswami D, Creighton SM, Conway GS. Swyer syndrome: presentation and outcomes. BJOG. 2008;115:737-41.

Sauer MV, Lobo RA, Paulson RJ. Successful twin pregnancy after embryo donation to a patient with XY gonadal dysgenesis. Am J Obstet Gynecol. 1989;161:380-1.

Cornet D, Alvarez S, Antoine JM, Tibi C, Mandelbaum J, Plachot M, et al. Pregnancies following ovum donation in gonadal dysgenesis. Hum Reprod. 1990;5:291-3.

Bardeguez AD, De Ziegler D, Weiss G. Multifetal pregnancy in a gonadal dysgenesis mosaic. Obstet Gynecol. 1990;76:502-4.

Bianco S, Agrifoglio V, Mannino F, Cefal u E,Cittadini E. Successful pregnancy in a pure gonadal dysgenesis with karyotype 46, XY patient (Swyer’s syndrome) following oocyte donation and hormonal treatment. Acta Eur Fertil. 1992;23:37-8.

Kan AK, Abdalla HI, Oskarsson T. Two successful pregnancies in a 46, XY patient. Hum Reprod. 1997;12:1434-5.

Dirnfeld M, Bider D, Abramovicia H, Calderon I,Blumenfeld Z. Subsequent successful pregnancy and delivery after intracytoplasmic sperm injection in a patient with XY gonadal dysgenesisms.Eur J Obstet Gynecol Reprod Biol. 2000;88:101-2.

Selvaraj K, Ganesh V, Selvaraj P. Successful pregnancy in a patient with a 46, XY karyotype. Fertil Steril. 2002;78:419-20.

Chen MJ, Yang JH, Mao TL, Ho HN, Yang YS. Successful pregnancy in a gonadectomized woman with 46, XY gonadal dysgenesis and gonadoblastoma. Fertil Steril. 2005;84:217.

Ko PC, Peng HH, Soong YK, Chang SD. Triplet pregnancy complicated with one hydatidiform mole and preeclampsia in a 46, XY female with gonadal dysgenesis. Taiwan J Obstet Gynecol. 2007;46:276-80.

Plante BJ, Fritz MA. A case report of successful pregnancy in a patient with pure 46, XY gonadal dysgenesis. Fertil Steril. 2008;90:2015.e1-2.

Siddique H, Daggett P, Artley K. Successful term vaginal delivery in a 46, XY woman. Int J Gynaecol Obstet. 2008;101:298-9.

Tulic I, Tulic L, Micic J. Pregnancy in patient with Swyer syndrome. Fertil Steril. 2011;95:1789.e1-2

Creatsas G, Deligeoroglou E, Tsimaris P. Successful pregnancy in a Swyer syndrome patient with preexisting hypertension. Fertil Steril. 2011;96:2.e83-5.

Mousavi A, Gilani, MM, Goodarzi S. Long‐term Disease Free and Successful Pregnancy in a Woman with Gonadal Dysgenesis and Malignant Germ Cell Tumor. Journal of Family and Reproductive Health. 2012;6:91-4.

Canonico M, Oger E, Conard J, Meyer G, Levesque H, Trillot N. Estrogen, Group THRS. Obesity and risk of venous thromboembolism among postmenopausal women: differential impact of hormone therapy by route of estrogen administration. The ESTHER Study. J Thromb Haemost. 2006;4:1259-65.