Endocrine Abstracts

Pregnancies in women with acromegaly are rare. Data from the literature report the absence of fetal malformation, a rarely symptomatic increase in adenomatous volume, a possible risk of gestational diabetes and gravidic hypertension in women not controlled before pregnancy. We report the case of a 32-year-old woman, nulliparous, who consults for spaniomenorrhea associated with chronic headaches, in whom the diagnosis of acromegaly was suspected in the face of a very discreet acquired dysmorphic syndrome. Endogenous hypersomatotropism that cannot be curbed by OGTT was confirmed, with the presence of a pituitary macro-adenoma measuring 12 mm long on the hypothalamic-pituitary MRI. Surgical management was referred to the discovery of an evolving pregnancy of 08 weeks of amenorrhea (SA). The pregnancy was carried to term without incident. The morphological reassessment made at three months post-partum objectified an increase in the volume of the adenoma with an extension to the right cavernous sinus, consequently adenomectomy by trans-sphenoidal way was carried out, with the persistence of a tumoral residue. A few months later, in the face of the non-taking of contraception and despite the non-control of the disease by medical treatment, a second spontaneous pregnancy was diagnosed, carried to term without incident except for headaches and vesicular lithiasis diagnosed in the second trimester. The patient underwent a cholecystectomy two months after delivery. A third spontaneous pregnancy was discovered one month later despite hypersomatotropism. The occurrence of pregnancy during acromegaly is a rare situation. The risk of increased tumor volume, pregnancy-induced hypertension and gestational diabetes are reported, however close monitoring of these patients is required.