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Pituitary apoplexy in pregnancy: A case series and literature review
Sophie Grand'Maison1, Florence Weber1, Marie-Josée Bédard2
1Internal Medicine Division, Department of Medicine, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada.
Background:
Severe headache during pregnancy is a challenging condition that may rarely imply endocrine disturbances. Rapid recognition of pituitary apoplexy is needed to improve pregnancy outcome.
Objective:
To review and compare maternal and fetal outcomes after pituitary apoplexy.
Methods:
Four cases of pituitary apoplexy during pregnancy in our centre are reported and literature review covering the past 54 years was performed.
Results:
In the four cases presented and the 33 reported in the literature, most women presented with severe headaches and systemic symptoms. Overall, 42% were treated surgically, 31% received bromocriptine or cabergoline and 61% were given hormone replacement. No major obstetrical complication was reported and all babies were healthy.
Conclusion:
Pituitary apoplexy is a rare cause of sudden and severe headache during pregnancy. Rapid identification of this condition with potentially associated endocrine disturbances is important to ensure maternal and fetal well-being. A multidisciplinary team approach seems to reduce morbidity and mortality.
