Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2014) 35 S18.1 | DOI: 10.1530/endoabs.35.S18.1

ECE2014 Symposia Endocrine disease during pregnancy (3 abstracts)

Pituitary tumours during pregnancy

Emese Mezosi


University of Pecs, Pecs, Hungary.


The morphology and function of pituitary gland are significantly altered in pregnancy. Complex changes can be seen at the level of pituitary and target hormones, binding globulins and the effect of placental hormones are also should be taken into consideration; this makes the diagnosis of pituitary dysfunction more complicated than in the non-pregnant stage. The incidence of pituitary adenomas in child-bearing age is 0.93/100 000. All pituitary tumors carry an increased risk for tumour growth. Differential diagnosis of pituitary gland enlargement involves pituitary adenoma, pituitary or tumour apoplexy and lymphocytic hypophysitis. Hormone secretion of pituitary adenomas may influence the outcome of pregnancy and the fetus. Based on the incidence, the effect on fertility and the first line medical treatment, prolactinomas represent the most common problem during pregnancy. The risk of growth in microprolactinomas is low and the dopamine agonist therapy can be stopped safely. The probability of tumour growth is much higher in macroprolactinomas, especially with suprasellar extension. Gestation should be delayed until tumour shrinkage. Adenomas partially unresponsive to dopamine agonist treatment need transsphenoidal surgery. Regular monitoring of clinical signs and visual disturbances is required during pregnancy; symptoms of tumour expansion indicate MRI. The use of bromocriptine and cabergoline is safe; however, the exposure of the fetus to any drug should be minimized. Acromegaly is rare in pregnancy due to impaired fertility of these patients; the risk of gestational diabetes, hypertension and cardiac complications is increased. The treatment of acromegaly usually should be delayed until delivery. Octreotide can be used in pregnant patients with compressive symptoms. Cushing’s disease during pregnancy results in markedly increased maternal and fetal morbidity and mortality. Metyrapone is the drug of choice for medical therapy. Decision about the surgery or medical therapy is made individually based on the severity of the disease and gestational age.

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