Visual failure from pituitary and parasellar tumours occurring with favourable outcome in pregnant women

Very few cases have been reported of a successful outcome after relief by operation of severe visual failure from a pituitary or other parasellar tumour during the late stages of pregnancy. Two such cases are recorded here together with the obstetric features and follow-up studies of more than three years. Usually the deterioration of vi sion occurs in the latter half of the pregnancy and recovers rapidly after delivery, whether the onset of labour has occurred spontaneously or after induction. In subsequent pregnancies vision deteriorates at an earlier stage and becomes even more marked. Some cases are now occurring even in pregnancies induced by modern fertility drugs. The treatment of choice whenever vision is seriously threatened at any stage of pregnancy is a surgical attack on the pituitary, followed by suitable replacement therapy to ensure that the pregnancy continues.