Antenatal treatment of a mother bearing a fetus with congenital adrenal hyperplasia.

The virilisation of a female fetus by overproduction of adrenal androgens secreted by an adrenal gland with 21-hydroxylase deficiency is well known. Although reconstructive genital surgery can greatly improve matters, the long term outlook for reproduction is extremely poor for many reasons, including anatomy. 2 The idea of prenatal treatment of 21hydroxylase deficiency by administering glucocorticoids to the mother to prevent virilisation was superficially extremely attractive. Where do we stand 15 years later?