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Pituitary diseases in pregnancy
1Center for Endocrinology, Metabolism, and Molecular Medicine, Northwestern University Medical School, Chicago, IL 60611, USA.
Seminars in Perinatology
|January 8, 1999
Summary
Pituitary adenomas, particularly prolactinomas, are common in pregnancy. Management strategies vary for microadenomas and macroadenomas, with bromocriptine often used safely.
Area of Science:
- Endocrinology
- Obstetrics
- Reproductive Medicine
Background:
- Pituitary adenomas are the most frequent pituitary disorder during pregnancy.
- Prolactinomas are the most common hormone-secreting pituitary adenomas, requiring management for fertility.
- Pregnancy can impact various pituitary disorders, necessitating careful monitoring and treatment adjustments.
Purpose of the Study:
- To review the management of common pituitary adenomas during pregnancy.
- To discuss the diagnosis and treatment of acromegaly and hypopituitarism in pregnant patients.
- To outline the approach to diabetes insipidus in pregnancy.
Main Methods:
- Literature review of pituitary disorders in pregnancy.
- Discussion of diagnostic challenges and treatment options for specific pituitary tumors.
- Emphasis on the safety and efficacy of medications like bromocriptine and desmopressin.
Main Results:
- Hyperprolactinemia must be corrected for fertility; bromocriptine is safe in early pregnancy.
- Microprolactinomas have a low risk of enlargement, while macroadenomas pose a higher risk.
- Acromegaly diagnosis is challenging; treatment may be deferred postpartum. Hypopituitarism requires steroid replacement. Borderline diabetes insipidus can be managed with desmopressin.
Conclusions:
- Management of pituitary adenomas in pregnancy requires individualized strategies based on tumor type and size.
- Close surveillance and timely intervention are crucial for maternal and fetal well-being.
- Pregnancy-related pituitary dysfunction, including hypopituitarism and diabetes insipidus, necessitates appropriate medical management.