1/101. pregnancy following bromocryptine therapy for the amenorrhoea-galactorrhoea syndrome due to a pituitary tumour.A woman developed amenorrhoea and galactorrhoea after partial removal of a pituitary tumor during pregnancy. Hyperprolactinaemia was supressed by therapy with bromocryptine (CB 154, Sandoz) resulting in cessation of galactorrhoea in two months, spontaneous menstruation after eight months, and pregnancy after twelve months.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/101. Successful pregnancy in a woman with acromegaly treated with somatostatin analog (octreotide) prior to surgical resection.A 27-year-old woman with a GH-secreting pituitary macroadenoma was treated with continuous s.c. infusion of octreotide prior to surgical resection. Subsequently, she was found to be 6 months pregnant. Fetal echographs were normal, the newborn had no malformation, and postnatal development was normal.- - - - - - - - - - ranking = 2keywords = pregnancy (Clic here for more details about this article) |
3/101. Rapid enlargement and recurrence of a preexisting intrasellar craniopharyngioma during the course of two pregnancies. Case report.Enlargement of preexisting pituitary adenomas during pregnancy is well documented, but this phenomenon is unusual for nonendocrine pituitary tumors such as craniopharyngiomas. Only six cases of craniopharyngioma have been reported as presenting during pregnancy. The authors describe a 19-year-old woman who presented with amenorrhea and galactorrhea caused by an intrasellar mass. Seven months later, when she was 20 weeks pregnant, the patient developed sudden visual dysfunction. Emergency transsphenoidal surgery was performed to restore visual function, and the tumor was found to be a craniopharyngioma. The patient had spontaneous labor and delivered a healthy infant at term. The tumor recurred 4 years later, during her second pregnancy, and was again entirely removed via a second transsphenoidal approach. She again had a normal term delivery. During the 5-year follow-up period she has demonstrated no endocrinological or visual dysfunction. Control magnetic resonance images have revealed no recurrence of the tumor. The transsphenoidal approach seems to be the safest procedure to use during pregnancy to achieve an immediate optic nerve decompression and to preserve pituitary function.- - - - - - - - - - ranking = 2keywords = pregnancy (Clic here for more details about this article) |
4/101. Clinical course of a pituitary macroadenoma in the first trimester of pregnancy: probable lymphocytic hypophysitis.Recent findings revealed that the clinical features of lymphocytic hypophysitis are more complicated than previously thought. It is rarely described in the first trimester of pregnancy and signs of meningeal irritation are infrequently reported. In this study, a pregnant woman in her first trimester of pregnancy with clinical and radiological characteristics of a pituitary macroadenoma is described. The patient's pituitary profile revealed a relatively low prolactin for her stage of pregnancy. Unusual findings were neck stiffness associated with headache, nausea and vomiting. She was treated conservatively. Spontaneous complete resolution of the pituitary mass in the postpartum period led us to conclude that the correct diagnosis should be hypophysitis. Hypophysitis should be considered in the differential diagnosis of a pituitary mass presenting in early stages of pregnancy with symptoms mimicking hyperemesis gravidarum and/or meningeal irritation.- - - - - - - - - - ranking = 4keywords = pregnancy (Clic here for more details about this article) |
5/101. Treatment of prolactin-secreting pituitary tumours in young women by needle implantation of radioactive yttrium.Twenty-one young female patients are described who presented with amenorrhoea, galactorrhoea or infertility, and were treated by 90Y pituitary implantation of 20,000 rads. There was no morbidity. In all patients serum prolactin values were elevated and radiographs of the pituitary fossa were abnormal. Observations are available for 1--76 months (mean 27) after implantation. The median fall in prolactin values was 60 per cent while there was no deterioration in pituitary function if normal pre-operatively. luteinizing hormone values, both basally and following gonadotrophin-releasing hormone, rose to normal after operation; several instances of sellar remodelling were observed radiologically, and no instance of relapse was found radiologically, biochemically or clinically. Thirteen patients desiring fertility have been observed since implantation; so far nine have become pregnant, in three instances without any additional therapy; since four patients became pregnant twice, a total of 13 pregnancies have occurred. No case of tumour expansion was observed during pregnancy. 90Y implantation can be considered as a therapeutic procedure in young female patients requiring fertility which is competitive with surgical methods, and together with a short course of bromocriptine if needed, could prove to be the treatment of choice.- - - - - - - - - - ranking = 0.5keywords = pregnancy (Clic here for more details about this article) |
6/101. Lymphocytic adenohypophysitis mimicking a pituitary macroadenoma.A 24-year-old woman developed headache and rapidly progressive visual disturbances during the last trimester of her first pregnancy. Magnetic resonance tomography (MRI) of the brain documented an intra- and suprasellar mass lesion. For preservation of vision, transsphenoidal microsurgical decompression was performed. Immediately postoperatively, visual acuity improved and hemianopia resolved. Histological examination yielded the diagnosis of primary lymphocytic adenohypophysitis. This is a rare inflammatory pituitary disease. There are no typical clinical, laboratory, or radiological findings that allow precise preoperative diagnosis. Even though this autoimmune disorder is principally steroid-responsive, an improvement of visual disturbances under steroid therapy cannot be predicted. Therefore, surgery is justified not only to establish the diagnosis, but also to restore vision by decompression of the optic nerves and the chiasm.- - - - - - - - - - ranking = 0.5keywords = pregnancy (Clic here for more details about this article) |
7/101. pregnancy in hyperprolactinemic infertile women treated with vaginal bromocriptine: report of two cases and review of the literature.Vaginal bromocriptine has proven safe and effective in treating hyperprolactinemic women. However, there has been no long-term clinical assessment regarding the influence of daily vaginal bromocriptine administration on the ability to conceive. This article presents two cases of successful pregnancy resulting from this alternative treatment. An infertile woman with an empty sella and hyperprolactinemia was treated with vaginal bromocriptine because of intolerance to oral administration. Prolactin levels were quickly normalized and no side effects occurred. Repeated postcoital tests during treatment proved normal. Twelve months later, the patient conceived. The therapy was discontinued during pregnancy, without complications. Although bromocriptine treatment was not resumed after delivery, postpartum prolactin levels were lower than before treatment and magnetic resonance imaging revealed an unchanged empty sella. Another patient with infertility and pituitary microadenoma with intolerance to oral dopaminergic agonists received the same treatment. Prolactin quickly fell to within the normal range. Vaginal bromocriptine was well tolerated and postcoital test results were not impaired. Tumor regression occurred and 10 months later the patient conceived. Despite bromocriptine withdrawal, no significant complications occurred during pregnancy. It can therefore be concluded that a couple's fertility does not appear to be significantly affected by the persistent local presence of bromocriptine.- - - - - - - - - - ranking = 1.5keywords = pregnancy (Clic here for more details about this article) |
8/101. Successful pregnancy in a woman with acromegaly treated with octreotide.OBJECTIVE: To report a successful pregnancy in a 43-year-old woman with acromegaly and treatment during pregnancy with the somatostatin analogue octreotide, to review the physiologic aspects of acromegaly during pregnancy, and to discuss treatment options. methods: A case report is presented, and the current literature is reviewed. RESULTS: In a 40-year-old woman with acromegaly and secondary amenorrhea, menstrual periods resumed after treatment with octreotide. At age 43 years, she became pregnant and decided to continue octreotide therapy because of the relatively large size of the tumor and severe headaches when use of the medication was discontinued. growth hormone and insulin-like growth factor i levels remained normal throughout pregnancy, and a normal full-term infant was born. Several months after delivery, severe cholecystitis developed, and the patient underwent laparoscopic cholecystectomy. CONCLUSIONS: This case report describes the oldest documented woman with acromegaly who has completed a pregnancy and only the second patient treated with octreotide for the entire pregnancy. During a normal pregnancy, placental growth hormone suppresses pituitary growth hormone secretion; in patients with acromegaly, pituitary growth hormone secretion remains autonomous. Treatment of acromegaly with octreotide, bromocriptine, irradiation, or surgical intervention may restore menses and fertility to women of reproductive age. bromocriptine has been used throughout pregnancy without teratogenic effects in many patients. octreotide has been used during the first trimester of pregnancy in seven other women with acromegaly (throughout pregnancy in one of those patients) and for the entire pregnancy in one woman with a thyrotropin-secreting pituitary tumor; no adverse effects were noted. Lanreotide was also used in one patient briefly during the first trimester without adverse consequences. Although the outcomes of the current and previous pregnancies have been favorable, insufficient data are available to recommend the routine use of octreotide in all pregnant women with acromegaly.- - - - - - - - - - ranking = 7.5keywords = pregnancy (Clic here for more details about this article) |
9/101. craniopharyngioma presenting during pregnancy 4 years after a normal magnetic resonance imaging scan: case report.OBJECTIVE AND IMPORTANCE: Craniopharyngiomas, epithelial tumors of the hypothalamic and pituitary region, are thought to have congenital origins. It has been postulated that hormonal influences may stimulate growth in adults. This report describes a case and reviews the literature. CLINICAL PRESENTATION: The case is discussed of a 39-year-old woman who experienced symptoms from a craniopharyngioma diagnosed during a pregnancy that resulted from in vitro fertilization. A magnetic resonance imaging scan performed 4 years previously had disclosed nothing abnormal. INTERVENTION: The patient underwent a right frontotemporal craniotomy with total resection of the suprasellar tumor, which was dissected from the pituitary stalk. CONCLUSION: This case suggests a possible link in the adult patient between the growth of this supposedly congenital tumor and hormonal stimulation.- - - - - - - - - - ranking = 2.5keywords = pregnancy (Clic here for more details about this article) |
10/101. octreotide LAR treatment throughout pregnancy in an acromegalic woman.We report a 24-year-old woman with active acromegaly despite pituitary surgery and irradiation who received continuous octreotide LAR treatment for the control of GH excess throughout her pregnancy. The patient delivered a healthy girl following an uneventful pregnancy. Despite a substantial materno-fetal transfer of octreotide, postnatal development was normal with length parameters around the 50th percentile at 3 months of age. In almost all previously described cases (n = 13) octreotide was stopped after the diagnosis of pregnancy was established. No side-effects of mother or fetus have been reported. octreotide treatment in pregnancy seems to be feasible and safe. Due to the still-limited number of reported cases, the potential benefits of octreotide treatment should be weighed carefully against its possible risks.- - - - - - - - - - ranking = 4keywords = pregnancy (Clic here for more details about this article) |
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