Endocrine Abstracts

Introduction: Pregnancy in patients with pituitary pathology is a rare and delicate situation. However, risks for the mother and the foetus as well as the consequences of pregnancy on the history of pituitary adenoma require close monitoring.

Goals: Illustrate through 5 observations the evolution of pituitary pathology during pregnancy.

Observations: 1st patient: 41-year-old followed for somatotropic pituitary macro adenoma for which she was operated on with treatment failure. Pregnancy occurred 2 years postoperatively, with a preconception IGF1 level twice normal; MRI performed at 10 WA showed regression in the size of the adenoma, without visual complications. The delivery was scheduled at 37 WA by cesarean section without complications. The patient breastfed for 20 days and then stopped when the tumor syndrome accentuated.

2nd patient: 29 years old, followed for somatotropic pituitary macro adenoma operated on twice by transsphenoidal approach with treatment failure, then received medical treatment. The pregnancy was uneventful with unassisted home birth without complications. The patient breastfed for 20 months, currently, the child is 30 months old with good psychomotor development.

3rd patient: 37 years old who presented during the second trimester of pregnancy with a Cushing syndrome on pituitary macroadenoma with visual complications. Treatment consisted of complete transsphenoidal resection at 13 weeks. The evolution was marked by the occurrence of a spontaneous abortion at 20 SA.

4th patient: 35 years old followed for Cushing disease operated on with recurrence. The indication for a surgical revision was posed after medical preparation which was stopped in front of the discovery of pregnancy. The revision surgery was planned after delivery. The pregnancy was carried to term without complications. The delivery was vaginal without complications. The patient breastfed for 12 months.

5th patient: 36 years old followed for Cushing disease for 2 years on pituitary microadenoma operated and complicated by corticotropic insufficiency in remission. The pregnancy occurred 3 months later with good clinical evolution. The delivery was vaginal without complications, and the patient did not breastfeed.

Conclusion: Pregnancy is rare in patients with pituitary adenoma. On the other hand, its occurrence most often requires multidisciplinary and close care to prevent maternal and fetal consequences.