Cirugía transesfenoidal en enfermedad de Cushing durante gestación: Report of one case

Verdugo, Cecilia; Alegría, Jorge R.; Grant, Carlos; Briano, Elena; Gonzalez, Maria Inés Zepeda; Meza, Héctor; Amthauer, Nancy; Paiva, Oriana; Vigueras, Rogelio; Madariaga, Jaime

doi:10.4067/s0034-98872004000100012

Cited by 10 publications

(2 citation statements)

References 12 publications

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“…We included 28 studies on transsphenoidal surgery of pituitary adenomas during pregnancy (28,49,124,135,153,157,168,169,170,171,172,173,174,175,176,177,178,179,180,181,182,183,184,185,186,187,188,189), see Appendix 5 Table 1 for the GRADE evidence, and Appendix 5 Table 2 for study details. Pituitary surgery was performed in 33 cases during pregnancy.…”

Section: Clinical Question V: Is Pituitary Surgery Safe For Pituitary Adenomas During Pregnancy?mentioning

confidence: 99%

ESE Clinical Practice Guideline on functioning and nonfunctioning pituitary adenomas in pregnancy

Luger

Broersen

Biermasz

et al. 2021

European Journal of Endocrinology

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Pregnancies are rare in women with pituitary adenomas, which may relate to hormone excess from secretory subtypes such as prolactinomas or corticotroph adenomas. Decreased fertility may also result from pituitary hormone deficiencies due to compression of the gland by large tumours and/or surgical or radiation treatment of the lesion. Counselling premenopausal women with pituitary adenomas about their chance of conceiving spontaneously or with assisted reproductive technology, and the optimal pre-conception treatment, should start at the time of initial diagnosis. The normal physiological changes during pregnancy need to be considered when interpreting endocrine tests in women with pituitary adenomas. Dose adjustments in hormone substitution therapies may be needed across the trimesters. When medical therapy is used for pituitary hormone excess, consideration should be given to the known efficacy and safety data specific to pregnant women for each therapeutic option. In healthy women, pituitary gland size increases during pregnancy. Since some pituitary adenomas also enlarge during pregnancy, there is a risk of visual impairment, especially in women with macroadenomas or tumours near the optic chiasm. Pituitary apoplexy represents a rare acute complication of adenomas requiring surveillance, with surgical intervention needed in some cases. This guideline describes the choice and timing of diagnostic tests and treatments from the pre-conception stage until after delivery, taking into account adenoma size, location and endocrine activity. In most cases, pregnant women with pituitary adenomas should be managed by a multidisciplinary team in a centre specialised in the treatment of such tumours.

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Section: Clinical Question V: Is Pituitary Surgery Safe For Pituitary Adenomas During Pregnancy?mentioning

confidence: 99%

ESE Clinical Practice Guideline on functioning and nonfunctioning pituitary adenomas in pregnancy

Luger

Broersen

Biermasz

et al. 2021

European Journal of Endocrinology

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show abstract

“…[ 10 52 ] Transsphenoidal surgery has been successfully performed in the second trimester in a small number of published case reports. [ 8 13 25 31 40 41 42 54 ]…”

Section: Discussionmentioning

confidence: 99%

Surgical management of recurrent Cushing′s disease in pregnancy: A case report

Abbassy¹,

Kshettry²,

Hamrahian³

et al. 2015

Surg Neurol Int

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Background:Cushing's disease is a condition rarely encountered during pregnancy. It is known that hypercortisolism is associated with increased maternal and fetal morbidity and mortality. When hypercortisolism from Cushing's disease does occur in pregnancy, the impact of achieving biochemical remission on fetal outcomes is unknown. We sought to clarify the impact of successful surgical treatment by presenting such a case report.Case Description:A 38-year-old pregnant woman with recurrent Cushing's disease after 8 years of remission. The patient had endoscopic transsphenoidal of her pituitary adenoma in her 18th week of pregnancy. The patient had postoperative biochemical remission and normal fetal outcome with no maternal complications.Conclusion:Transsphenoidal surgery for Cushing's disease can be performed safely during the second trimester of pregnancy.

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La terapia degli adenomi ipofisari in gravidanza

Cozzi

Attanasio

2007

L'Endocrinologo

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Cirugía transesfenoidal en enfermedad de Cushing durante gestación: Report of one case

Cited by 10 publications

References 12 publications

ESE Clinical Practice Guideline on functioning and nonfunctioning pituitary adenomas in pregnancy

ESE Clinical Practice Guideline on functioning and nonfunctioning pituitary adenomas in pregnancy

Surgical management of recurrent Cushing′s disease in pregnancy: A case report

La terapia degli adenomi ipofisari in gravidanza

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