Maternal androgen excess and female pseudohermaphroditism etiology

Embryology

What could be the cause of maternal adrenals to secrete high levels of androgen in the case of fetal female pseudohermaphroditism syndrome?

Females that exhibit this condition are often born to mothers who experience similar masculinization during their pregnancy. The cause is a hormonal imbalance, through which the female overproduces androgen. Polycystic ovary syndrome can be one potential cause of excessive androgen secretion that stimulates maternal and fetal masculinization during the pregnancy. In one case, "when newborn with female pseudohermaphroditism (profound masculinization of the external genitalia and preservation of the internal female genitalia) was present, during the woman's pregnancy "progressive hirsutism was noted in the mother, and polycystic ovaries were found at cesarean section. The serum testosterone level in the cord blood was elevated markedly (Bilowus, Abbassi, & Gibbons 1986, p.1098).

Another possible cause, only recently documented for maternal virilization during pregnancy and the pseudohermaphroditism of the female fetus, where maternal serum levels of estrogens were low, and those of androgens were high in the third trimester is that of placental aromatase deficiency.... The rate of aromatization by normal control placentas was the same as that obtained during coincubation of samples of normal placentas and that of the patient. Thus, the presence of aromatase inhibitor in the patient's placenta was excluded" (Shozu, et.al 1991).