ECE2015 Guided Posters Pituitary–Acromegaly (10 abstracts)
Clinical and biochemical outcomes during pregnancy in patients with acromegaly
Triona O’Shea 1 , Saket Guptha 1 , Audrey Melvin 2 , Karen McGurran 1 , Ruth Casey 2 , Donal O’Halloran 2 , James Gibney 3 , Christopher Thompson 1 & Mark Sherlock 3
1Beaumont Hospital, Dublin 9, Ireland; 2Cork University Hospital, Cork, Ireland; 3Tallaght Hospital, Dublin, Ireland.
Acromegaly is a rare condition resulting from excess secretion of GH and IGF1. Acromegaly is frequently associated with subfertility. As such there is little data on the course of the disease during pregnancy, and of the effects of the disease and its treatments on the foetus.
Objective: We describe known pregnancies in women with acromegaly within the Republic of Ireland over a 15-year period.
Methods: We collected clinical, biochemical, and outcome data during and following pregnancy.
Results: We have identified 11 pregnancies in eight women. All women had a pituitary macroadenoma. In eight cases there was concurrent prolactin hypersecretion. Ten out of 11 patients were medically treated prior to conception. Dopamine agonists were most commonly used (8/11) followed by somatostatin analogues (4/11). One patient was treated with both dopamine agonists and somatostatin analogues. In 7/11 cases dopamine agonist therapy was continued throughout the pregnancy. Median IGF1 at conception was 240% above the upper limit of the age related reference range (IQR 230–380%). At the time of conception 2/11 cases had IGF1 levels within the age related reference range. During the third trimester IGF1 was within the reference range in 6/10 cases, and in all cases IGF1 levels fell during pregnancy. One patient was treated for hypertension throughout two pregnancies. No patient developed diabetes mellitus or any neurological complications during pregnancy. All babies were delivered via elective Caesarean section at term. Four babies were breastfed post delivery. Mean birth weight was 2.8 kg, with no cases of macro- or microsomia.
Conclusions: Our data suggests that pregnancy in acromegalic women is not associated with excess morbidity to mother or baby. There is a high rate of Caesarean section. Our data correlates with previous studies showing a beneficial effect of pregnancy on biochemical control of acromegaly.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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