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Visual loss during pregnancy due to physiological pituitary hyperplasia
Andrew Peel1, Stephanie Teasdale1, Adam Morton1
1Mater Hospital Brisbane, South Brisbane, Queensland, Australia.
Obstetric Medicine
|May 26, 2025
Summary
Physiological pituitary hyperplasia during pregnancy can cause vision loss. This condition resolved naturally postpartum, demonstrating the temporary nature of pituitary enlargement and the effectiveness of conservative management.
Area of Science:
- Endocrinology
- Neuro-ophthalmology
- Obstetrics
Background:
- Physiological pituitary hyperplasia involves an increase in adenohypophyseal cell number, leading to pituitary enlargement.
- It commonly affects females during reproductive transitions like pregnancy.
Purpose of the Study:
- To report a case of pituitary hyperplasia presenting with visual changes during pregnancy.
- To discuss the management and outcome of this condition.
Main Methods:
- A case study of a 33-year-old pregnant female with visual disturbances.
- Diagnostic assessments included visual field testing and retinal nerve fiber layer assessment.
- Management involved serial visual assessments and delivery via cesarean section.
Main Results:
- The patient presented with pituitary hyperplasia (14 mm height) and right superotemporal visual field loss, indicative of compressive optic neuropathy.
- Following delivery at 38 weeks gestation, visual symptoms resolved, and pituitary height decreased to 11 mm.
- Conservative management without pharmacotherapy (e.g., cabergoline) was successful.
Conclusions:
- Pituitary hyperplasia during pregnancy can cause reversible compressive optic neuropathy.
- Conservative management and delivery can lead to positive visual outcomes.
- This case highlights the transient nature of pregnancy-induced pituitary hypertrophy.
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