Endocrine Abstracts

Limited data are available about pregnancy in acromegalic women. Forty-three women, 32±1 years, presented GH hypersecretion (GH=44±7 ng/ml, IGF-1=1009±82 ng/ml) due to micro (n=6) or macroadenoma (n=37). Thirty-six women had transsphenoidal incomplete surgical resection and 9 external radiation of the pituitary adenoma performed 2.8±0.5 and 7.1±3.3 years before pregnancy. Women received dopamine agonists (n=6), somatostatin analogues (n=11) or both (n=12), and GH/IGF-1 hypersecretion was considered as cured (n=6), uncontrolled (n=15) or controlled (n=22). Pregnancies were reported after spontaneous conception (n=54) or with fertility treatment (n=5). Women had spontaneous abortion (n=1), early termination of pregnancy (n=2), or delivered single (n=51) or twin (n=5) healthy infants without any malformation. The mean birth weight was 3250±85 grs. Maternal diabetes mellitus, hypertension and eclampsia occur during 4, 4 and 3 pregnancies, and were not correlated with GH/IGF-1 hypersecretion. Headaches were reported by 28% of women. Visual abnormalities were observed in undiagnosed acromegaly before pregnancy (n=2) or invasive (n=2) macroadenoma, and patients required medical (n=4) or surgical (n=1) treatment during pregnancy. Breastfeeding was observed in 18 women without any complication. In conclusion, GH/IGF-1 hypersecretion do not increase metabolic and cardiovascular complications during pregnancy of acromegalic women. Pregnancy is associated with symptomatic tumor enlargement is undiagnosed or invasive macroadenomas. GH/IGF-1 hypersecretion and medical treatment did not increase the risk of miscarriage or congenital malformation. Therefore, pregnancy is not contraindicate in women with acromegaly, but acromegalic women should be clinically evaluated for metabolic, cardiovascular or tumor enlargement symptoms during the course of pregnancy.