Evaluation and management of pituitary tumors during pregnancy.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
M E Molitch

Abstract

To review the recommended management of pituitary tumors that occur in pregnant patients. Studies from the literature and personal experience are summarized, and guidelines for optimal maternal and fetal outcome are suggested. Tumors are the most common pituitary disorder affecting pregnant patients. Hyperprolactinemia must be corrected to allow ovulation and fertility. Bromocriptine has been shown to be safe for use during early gestation. Patients have less than a 2% risk of microprolactinoma enlargement during pregnancy but approximately a 16% risk of symptomatic enlargement of a macroprolactinoma. Treatment options for patients with macroadenomas include discontinuing bromocriptine therapy when pregnancy is confirmed and reinstituting this treatment if the tumor enlarges; continuous bromocriptine therapy throughout the pregnancy; and prepregnancy surgical debulking of the tumor. The diagnoses of acromegaly and Cushing's disease are difficult to make during pregnancy. The hormone oversecretion in these conditions may exacerbate tendencies to gestational diabetes, fluid retention, and hypertension. Cushing's syndrome should be treated during pregnancy, but treatment for acromegaly and other tumors may be deferred. Rare report...Continue Reading

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Citations

Jan 20, 2007·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Imad T ZakKarl K Kish
Oct 7, 2011·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·J E A K BamfoM Golara
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Mar 18, 2008·Arquivos de neuro-psiquiatria·José Carlos LynchMarcos Machado D'Ippolito
Jun 26, 2001·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·J M Neal

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