ECE2018 Guided Posters Acromegaly (11 abstracts)
Pregnancy and acromegaly – clinical outcomes from the Irish Pituitary Network
Anne Marie Hannon 1 , Triona O’Shea 1 , Rosemary Dineen 2 , Aftab Khattak 3 , Domhnall O’Halloran 3 , Steven Hunter 4 , Mark Sherlock 2 & Chris Thompson 1
1Academic Department of Endocrinology, Beaumont Hospital, Dublin, Ireland; 2Department of Endocrinology and Diabetes, Adelaide and Meath Hospital, Dublin, Ireland; 3Department of Endocrinology and Diabetes, Cork University Hospital, Cork, Ireland; 4Department of Endocrinology and Diabetes, Royal Victoria Hospital, Belfast, UK.
Acromegaly is a rare disease characterised by excessive Growth hormone (GH) production from a pituitary adenoma. Subfertility is common in acromegaly and has various aetiologies, therefore pregnancy in acromegaly is rare. We present a case series of 19 pregnancies in 13 women with acromegaly from the newly formed Irish National Pituitary Registry. Twelve women had pituitary macroadenomas, one woman had a microadenoma. The age of the women ranged from 28 to 40 years with a median of 34 years. Only 5/19 pregnancies had optimal biochemical control of acromegaly pre-conception, as defined by IGF-1 concentration in the age-related reference level and plasma GH concentration of <2 μg/l. There were 18 singleton pregnancies and one twin pregnancy. Four women were receiving treatment with somatostatin analogues pre-pregnancy, all 4 women discontinued therapy with the first positive pregnancy test. No woman continued somatostatin analogue treatment during pregnancy. All 4 of these pregnancies had normalisation of the plasma IGF-1 concentration in spite of the withdrawal of somatostatin analogue therapy. 7/19 pregnancies continued dopamine agonist treatment during pregnancy.
Effect of pregnancy on acromegaly; No patient had a change in visual field during pregnancy. 9/14 IGF-1 plasma concentrations that were elevated pre-conception normalized during pregnancy, with a reduction in IGF-1 seen in a further 4 pregnancies.
Effect of acromegaly on pregnancy; 17 healthy babies were born at term. 1/19 pregnancies had pre-eclampsia and an emergency C-section was performed at 32 weeks. 1/19 pregnancies (twin pregnancy) had an elective caesarean section at 35 weeks. 0/19 pregnancies developed gestational diabetes.
Our data suggests that pregnancy in women with acromegaly is generally safe, from a maternal and foetal perspective. Furthermore, biochemical control tends to improve in spite of the withdrawal somatostatin analogue therapy during pregnancy.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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