If ACTH independent, it is due to the autonomous function of one or both adrenal glands, including adrenal adenomas, adrenocortical carcinomas, and micronodular or macronodular hyperplasia. The clinical manifestations of Cushing's syndrome are protean and reflect the catabolic actions of cortisol on skin, muscle, bone, liver, and fat.
Prior to pregnancy and into much of the third trimester your cervix is long and thick. As labor nears it begins to shorten and thin out. This action is referred to as effacement. Effacement is generally measured in percentages by doctors and midwives.
Puffy ankles are common during pregnancy and though it causes discomfort to you it is a sign that your pregnancy is going just the way it should be. Almost 3 in every 4 pregnant women experience edema, and it starts somewhere around weeks 22 and 27 of pregnancy.