Pituitary and adrenal disorders complicating pregnancy

Current Opinion in Obstetrics and Gynecology

Volumn 15, Issue 2, 2003, Pages 101-106

  Chandraharan, Edwin ^a   Arulkumaran, Sabaratnam ^b  

^a ST GEORGE S HOSPITAL   (United Kingdom)

^b ST GEORGE'S UNIVERSITY OF LONDON   (United Kingdom)

Author keywords

Acromegaly; Carney complex; Cushing's disease; Phaeochromocytoma; Pituitary adenoma

Indexed keywords

AMILORIDE; ANGIOPEPTIN; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; BROMOCRIPTINE; CABERGOLINE; CORTICOTROPIN; CYPROHEPTADINE; DEXAMETHASONE; GROWTH HORMONE; HYDROCORTISONE; KETOCONAZOLE; LABETALOL; METHYLDOPA; METYRAPONE; NIFEDIPINE; OCTREOTIDE; PHENOXYBENZAMINE; PRAZOSIN; PROLACTIN; SPIRONOLACTONE;

ACROMEGALY; ADRENAL CORTEX CARCINOMA; ADRENAL DISEASE; ADRENALECTOMY; AUTOSOMAL DOMINANT DISORDER; CARNEY COMPLEX; CLINICAL PRACTICE; COMPUTER ASSISTED TOMOGRAPHY; CORTICOTROPIN BLOOD LEVEL; CUSHING DISEASE; CUSHING SYNDROME; DEXAMETHASONE SUPPRESSION TEST; DIABETES MELLITUS; DIAGNOSTIC IMAGING; DRUG SAFETY; ECHOGRAPHY; ENDOSCOPIC SURGERY; FEMALE; HEART ARRHYTHMIA; HEART MYXOMA; HUMAN; HYPERPROLACTINEMIA; HYPERTENSION; HYPOKALEMIA; HYPOPHYSIS ADENOMA; HYPOPHYSIS APOPLEXY; HYPOPHYSIS DISEASE; HYPOPHYSIS TUMOR; LENTIGINOSIS; MATERNAL MORTALITY; MULTIPLE CANCER; NAUSEA; NELSON SYNDROME; NERVE SHEATH TUMOR; NUCLEAR MAGNETIC RESONANCE IMAGING; PHEOCHROMOCYTOMA; PRACTICE GUIDELINE; PREGNANCY; PREGNANCY COMPLICATION; PRIMARY HYPERALDOSTERONISM; PRIORITY JOURNAL; PROLACTIN RELEASE; REVIEW; SKIN PIGMENTATION; TERATOGENESIS; TRANSSPHENOIDAL HYPOPHYSECTOMY; TREATMENT OUTCOME; UNITED KINGDOM;

ADRENAL GLAND NEOPLASMS; ANTINEOPLASTIC AGENTS; ENDOSCOPY; FEMALE; HUMANS; OCTREOTIDE; PEPTIDES, CYCLIC; PITUITARY NEOPLASMS; PREGNANCY; PREGNANCY COMPLICATIONS, NEOPLASTIC; PRENATAL CARE; PRENATAL DIAGNOSIS; SOMATOSTATIN;

EID: 0037388117     PISSN: 1040872X     EISSN: None     Source Type: Journal    
DOI: 10.1097/00001703-200304000-00003     Document Type: Review

References (27)

1. Gonsalez JG, Elizondo G, Saldwar D, et al. Pituitary gland growth during normal pregnancy: an in vivo study using MRI. Am J Med 1988; 85:217-220.
2. Mastarakos G, Ilias I. Maternal hypothalamo-pituitary adrenal axis in pregnancy and the postpartum period: postpartum related disorders. Ann NY Acad Sci 2000; 900:95-106.
3. Harrington JI, Farley DR, Van Heerden JA, Ramin KD. Adrenal tumours and pregnancy. World J Surg 1999; 23:182-186.
4. Molitch ME. Management of prolactinaemia during pregnancy. J Reprod Med 1999; 44 (Suppl 12):1121-1126.
5. Liu C, Tyrell RB. Successful treatment of a large macroprolactinoma with cabergoline during pregnancy. Pituitary 2001; 4:179-185.
6. Ricci G, Giolo E, Nucara G, et al. Pregnancy in hyperprolactinaemic infertile women treated with vaginal bromocryptine: report of two cases and review of the literature. Gynecol Obstet Invest 2001; 51:266-270.
7. Jan M, Destrieux C. Pituitary disorders in pregnancy. Neurochirugie 2000; 46:88-94.
8. Mallman ES, Nacul A, Spritzer PM. Pregnancy in hyperprolactinaemic women. Acta Obstet Gynecol Scand 2002; 81:265-267.
9. Herman-Bonert V, Seliverstov M, Melmed S. Pregnancy in acromegaly: successful therapeutic outcome. J Clin Endocrinol Metab 1998; 83:727-731.
10. Raymond JP, Goldstein E, Kanopka P, et al. Follow up of children born to bromocryptine treated women. Horm Res 1985; 22:239-246.
11. Neal JM. Successful pregnancy in a woman with acromegaly, treated with octreotide. Endocr Pract 2000; 6:148-150.
12. Ernesto de Mendis, Domenico B, Elisabetta M. Uneventful pregnancy in a patient treated with slow release lanreotide: a case report. J Clin Endocrinol Metab 1999; 84:1489-1492.
13. Caron P, Buscail L, Beckers A, et al. Expression of somatostatin receptor SST4 in human placenta and the absence of octreotide effect on human placental growth hormone concentration during pregnancy. J Clin Endocrinol Metab 1997; 82:3771-3776.
14. Fassnacht M, Capeller B, Arlt W, et al. Octreotide LAR treatment throughout pregnancy in an acromegalic woman. Clin Endocrinol (Oxford) 2001; 55:411-415. The authors report the use of octreotide and lanreotide for the control of growth hormone excess throughout pregnancy, and report no adverse effects on the fetus. The neonate was also followed for 3 months. The study suggests that in selected patients, octreotide may be used in pregnancy to optimize the outcome, without compromising safety.
15. Aydin Y, Can SM, Gulklilik A, et al. Rapid enlargement and recurrence of a pre-existing intrasellar craniopharyngioma during the course of two pregnancies. Case report. J Neurosurg 1999; 91:322-324.
16. Shah S, Har-El G. Diabetes insipidus after pituitary surgery: incidence after traditional versus endoscopic transphenoidal approaches. Am J Rhinol 2001; 15:377-379. A good study involving 81 patients to assess short-term and long-term postoperative diabetes insipidus in patients who underwent traditional transphenoidal surgery and those who underwent a transnasal endoscopic procedure. There was a decrease in the incidence of diabetes insipidus in the immediate postoperative period in the endoscopic group. However, there was no difference on long-term follow-up.
17. Schulz S, Redlich A, Koppe I, et al. Carney complex: an unexpected finding during the puerperium. Gynecol Obstet Invest 2001; 51:211-213.
18. Watson JC, Stratakis CA, Bryant-Greenwood PK, et al. Neurosurgical implications of Carney complex. J Neurosurg 2000; 92:413-418.
19. Reschke K, Klose S, Mohnike K, et al. Manifestation of Cushing's syndrome and osteoporotic fractures in pregnancy in a patient with Carney complex. Med Kiln 2002; 97:91-95.
20. Close CF, Mann MC, Watts JF, Taylor KG. ACTH-dependent Cushing's syndrome in pregnancy with spontaneous resolution after delivery: control of the hypercorticolism with metyrapone. Clin Endocrinol (Oxford) 1993; 39:375-379.
21. Hana V, Dokoupilova M, Marek J, Plavka R. Recurrent ACTH-dependent Cushing's syndrome in multiple pregnancies and its treatment with metyrapone. Clin Endocrinol (Oxford) 2001; 54:277-281.
22. Berwaerts J, Verhelst J, Mahler C, Abs R. Cushing's syndrome in pregnancy treated by ketoconozole: case report and review of the literature. Gynecol Endocrinol 1999; 13:175-182.
23. Lo CY, Lo CM, Lam KY. Cushing's syndrome secondary to adrenal adenoma during pregnancy. Surg Endosc 2002; 16:219-220. The authors describe two different ways of managing Cushing's syndrome by laparoscopic adrenalectomy both during and after pregnancy.
24. Lesage J, Blondeau B, Grino M, et al. Maternal undernutrition during late gestation induces fetal over-exposure to glucocorticoids and intrauterine growth restriction (IUGR) and disturbances in the hypothalamo-pituitary-adrenal axis in the new born rat. Endocrinology 2001; 142:1692-1702.
25. Tewaris KS, Steiger RM, Lam LM, et al. Bilateral phaeochromocytoma in pregnancy heralding MEN syndrome IIA: a case report. J Reprod Med 2001; 46:385-388. This is the first case of multiple endocrine neoplasia type IIA reported in pregnancy. A high degree of clinical suspicion in view of the bilateral phaeochromocytomas helped clinch the diagnosis. This early and accurate diagnosis during pregnancy enabled subsequent prophylactic thyroidectomy before the development of medullary carcinoma.
26. Finkenstedt G, Gasser RW, Hofle G, et al. Phaeochromocytoma and subclinical Cushing's syndrome during pregnancy: diagnosis, medical pre-treatment and cure by laparoscopic unilateral adrenalectomy. J Endocrinol Invest 1999; 22:555-557.
27. Pace DE, Chiasson PM, Schlach CM, et al. Minimally invasive adrenalectomy for phaeochromocytoma during pregnancy. Surg Laparosc Endosc Percutan Tech 2002; 12:122-125. This is the second reported case of laparoscopic adrenalectomy for phaeochromocytoma, which was carried out at the beginning of the second trimester with a good obstetric outcome. This report re-enforces the role of minimal access surgery during pregnancy in the treatment of adrenal tumours.