Endocrine Abstracts

Silent pituitary adenomas are defined as a group of adenomas that are hormonally inactive and do not show clinical signs and symptoms of excess hormones. Data in the literature indicate that fertility is usually affected in women with silent pituitary adenomas.

Aim: To investigate the possible effects of silent pituitary adenomas on pregnancy.

Patients and method: Thirty patients followed by silent pituitary adenoma, without hormone deficiency or excess, not receiving medical treatment were included in the study. Anterior pituitary hormone levels, follow-up periods, pituitary magnetic resonance imaging findings, number of gravidity, parity, abortus, ectopic pregnancy, stillbirths, presence of symptoms associated with adenoma size increase during pregnancy, adverse pregnancy outcomes, induction of labor history, delivery procedures, pregnancy week at delivery, birth weight, lactation duration were evaluated.

Results: The mean age of the patients was 41.26 ± 9.06 years and the mean duration after the diagnosis was 92,8 months. Of the 30 patients with silent pituitary adenoma, 7 were followed by macroadenoma and 23 with microadenoma. Among all 92 pregnancies, 66 resulted in live births. No statistically significant difference was found between pregnancy week at delivery, birth weight, lactation duration in live births in macroadenoma and microadenoma groups. However, there was a statistically significant difference between the two groups with respect to adenoma size, the incidence of nausea-vomiting and visual impairment during pregnancy were more prominent in macroadenoma with respect to microadenoma (P = 0.016 and P = 0.042, respectively).

Discussion: Elective abortion, missed abortion, stillbirth, live birth rates and lactation duration are thought to be similar to the general population. In our study, spontaneous pregnancy rates were found to be high and no negative effects of silent pituitary adenomas on fertility were observed. Although rarely reported in the literature, there is an increase in the size of silent pituitary adenomas during pregnancy, however, no adenoma growth confirmed by MRI was observed in our study. In terms of pregnancy-related complications, silent pituitary adenoma was not associated with increased risk compared to the general population and there was no obvious negative effect on fetal development. Despite the high cesarean section rates in our country, silent pituitary adenomas were not associated with an increased cesarean section rate in our study. In conclusion, when the present findings are evaluated together, it is not possible to mention that the patients followed up with silent pituitary adenoma have negative effects on pregnancy outcomes, fetal development, and lactation.