Gestational Pituitary Apoplexy With Persistent Hypogonadotropic Hypogonadism

Pituitary apoplexy (PA) is a rare and life-threatening emergency that remains prone to misdiagnosis, especially in pregnancy. Few cases of gestational PA have been reported in the literature.

This study reports a case of a 26-year-old woman presenting at 35 weeks of gestation with PA.

Initial presentation included severe headache, blurry vision, and dizziness, and conservative medical management was opted. This included stress-dose hydrocortisone, cabergoline, and levothyroxine, followed by cesarean delivery at 36 weeks of gestation. The patient retrieved normal pituitary function, except for persistent amenorrhea 2 years after.

This is the first case of isolated persistent hypogonadotropic hypogonadism following PA in a pregnant patient and opens the discussion on the variety of potential complications of this condition.