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Major Hormones and Their Functions01:27

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Hormones, the biochemical messengers produced by endocrine glands, are pivotal in regulating bodily functions and maintaining homeostasis. Each hormone's balance is crucial; imbalances can lead to significant physiological disruptions. Major hormones include oxytocin, cortisol, epinephrine, estrogen, testosterone, thyroxine, growth hormone, insulin, and glucagon.
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Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
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The pituitary is a small endocrine organ in the sphenoid bone under the hypothalamus. Primarily, the pituitary in adults has two distinct anatomical and functional regions— the anterior and posterior lobes. During human fetal development, a third pituitary gland region called the pars intermedia atrophies and disappears. However, some of its cells migrate and exist adjacent to the anterior pituitary in adults.
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Pituitary disease and pregnancy.

Elena Valassi1

  • 1Grupo "Enfermedades de Hipófisis" (CIBERER 747), II-B Hospital Sant Pau, Barcelona, España; Servicio de Endocrinología, Hospital General de Catalunya, Sant Cugat del Vallès, España.

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|December 28, 2020
PubMed
Summary

Managing pituitary adenomas during pregnancy is complex due to physiological changes. This review offers guidance on diagnosis, treatment, and monitoring of pituitary tumors in pregnant women.

Keywords:
Adenomas hipofisariosGestaciónHipopituitarismoHipófisisHypopituitarismPituitary adenomaPituitary glandPregnancy

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Area of Science:

  • Endocrinology
  • Obstetrics
  • Reproductive Medicine

Background:

  • Pregnancy significantly alters pituitary gland size and function.
  • Pituitary diseases pose diagnostic and management challenges during pregnancy.
  • Limited data exists on the safety of medications for hormone excess during pregnancy.

Purpose of the Study:

  • To review diagnostic challenges of pituitary adenomas in pregnant women.
  • To provide evidence-based recommendations for managing pituitary adenomas during pregnancy.
  • To discuss hormone replacement therapy and differential diagnoses of pituitary disorders in pregnancy.

Main Methods:

  • Literature review focusing on pituitary adenomas (prolactinomas, growth hormone-secreting, ACTH-secreting) in pregnancy.
  • Examination of treatment safety and efficacy data.
  • Analysis of diagnostic algorithms and monitoring strategies.
  • Discussion of hypopituitarism management and differential diagnosis of Sheehan's syndrome and lymphocytic hypophysitis.

Main Results:

  • Physiological changes in pregnancy complicate pituitary adenoma diagnosis and management.
  • Safety data for common hormonal drugs during pregnancy is scarce.
  • Pituitary adenoma growth risk exists during pregnancy.
  • Specific recommendations for managing prolactinomas, GH-secreting, and ACTH-secreting adenomas are presented.
  • Optimized hormone replacement and differential diagnosis strategies are discussed.

Conclusions:

  • Effective management of pituitary adenomas in pregnancy requires careful consideration of diagnostic and therapeutic challenges.
  • Evidence-based guidelines and monitoring algorithms are crucial for optimizing maternal and fetal outcomes.
  • Further research is needed to address safety concerns regarding medications used during pregnancy.