Endocrine Abstracts

Acromegaly is usually caused by a GH-secreting pituitary adenoma. Although fertility is frequently impaired, pregnancy can be possible due to improvement in diagnosis and treatment modalities. Tumour enlargement and nontumoral lactotroph enlargement related with pregnancy can compress the optic chiasm and cause visual impairment. Optimal management of acromegaly during pregnancy is not well established. In this paper our experience about the clinical, laboratory, radiologic data and maternal–fetal outcomes of our pregnant acromegalic patient is presented. A 38 years old patient had been diagnosed as acromegaly when she was 31 years old. She was operated for a 35×30 mm cystic macroadenoma and followed with somatostatin analogue treatment. 3 years after the operation she became pregnant and octreotide-LAR treatment was halted at 3 months of pregnancy. She was not overweight and she did not have hypertension before pregnancy. After delivery GH levels elevated and octreotide-LAR treatment was restarted and continued throughout lactation. Headache without visual abnormalities developed during pregnancy, but tumour growth could not be demonstrated postpartum at imaging of pituitary. She delivered a healthy baby without complications related with acromegaly. The child is 4-year-old now and healthy. It can be concluded that uneventful course of pregnancy and delivery is possible with drug treatment withdrawal in acromegalic patients, but close follow-up is mandatory after delivery, due to recurrent nature of the disease.