Objective: To determine the outcome of pregnancy in hypopituitary women.
Background: Rare situation, not studied enough: only two previous studies concerning 9 and 19 patients (Overton et Hall).
Design: Multicentric, descriptive, prospective and retrospective study.
Material and methods: Twenty-one pregnancies were registered in 14 hypopituitary women (defined as gonadotropic deficiency associated with at least another pituitary deficiency) with median age 32.5 years (2741), from 3 French endocrinology centers in the universitary hospitals of Paris (Kremlin-Bicêtre), Toulouse and Grenoble.
Results: The primary outcome was the pregnancy: 93% of patients completed at least one pregnancy. Twenty-one pregnancies were obtained with 17 live births (1 set of twins and 5 miscarriages).
The secondary outcomes were the results of ovulation induction: 95% of ovulation and 56% of pregnancies by stimulation with gonadotrophins; the results of luteal phase support which were better with hCG (associated or not with progesterone), than with progesterone alone; the adaptations of levothyroxine and the other substitutive therapies.
Pregnancy or deliveriescomplications, newborns health and measurements were also studied. Two complications were noted: oligo-hydramnios and pre-eclampsia, but no acute hypophyseal deficiency. About 62.5% of patients had a physiological delivery.
The 17 newborns were healthy, with median length 50 cm (4552) and median weight 3234 g (20804250), two of them were under the 3th percentile.
Conclusion: Pregnancy can be considered and managed in hypopituitary women, it requires the collaboration of endocrinologists, reproductive physicians and obstetricians for a successful outcome.
25 - 29 Apr 2009
European Society of Endocrinology