Hypopituitarism and pregnancy: clinical characteristics, management and pregnancy outcome
Por:
Aulinas, A, Stantonyonge, N, Garcia-Patterson, A, Adelantado, JM, Medina, C, Espinos, JJ, Lopez, E, Webb, SM, Corcoy, R
Publicada:
1 abr 2022
Ahead of Print:
1 nov 2021
Resumen:
Purpose To describe the clinical characteristics, management and pregnancy outcome of women with prepregnancy hypopituitarism (HYPO) that received care at our center. Methods Retrospective study describing 12 pregnancies in women with prepregnancy HYPO (two or more pituitary hormonal deficiencies under replacement treatment) that received care during pregnancy at Hospital Santa Creu i Sant Pau. Clinical characteristics, management and pregnancy outcome were systematically collected. Results Average patients' age was 35 years and HYPO duration at the beginning of pregnancy was 19 years. The most frequent cause of HYPO was surgical treatment of a sellar mass (8 pregnancies). Eight pregnancies were in primigravid women and 10 required assisted reproductive techniques. The hormonal deficits before pregnancy were as follows: GH in 12 women, TSH in 10, gonadotropin in 9, ACTH in 5 and ADH in 2. All deficits were under hormonal substitution except for GH deficit in 4 pregnancies. During pregnancy, 4 new deficits were diagnosed. The dosage of replacement treatment for TSH, ACTH and ADH deficits was increased and GH was stopped. Average gestational age at birth was 40 weeks, gestational weight gain was excessive in 9 women, 8 patients required induction/elective delivery and cesarean section was performed in 6. Average birthweight was 3227 g. No major complications were observed. Five women were breastfeeding at discharge. Conclusions In this group of women with long-standing HYPO, with careful clinical management (including treatment of new-onset hormonal deficits) pregnancy outcome was satisfactory but with a high rate of excessive gestational weight gain and cesarean section.
Filiaciones:
Aulinas, A:
ISCIII, Ctr Invest Biomed Red Enfermedades Raras CIBERER, Unidad 747, Barcelona, Spain
Univ Vic, Dept Med, Cent Univ Catalonia, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Inst Recerca, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr, Barcelona, Spain
Stantonyonge, N:
Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr, Barcelona, Spain
Univ Autonoma Barcelona, Dept Med, Barcelona, Spain
Garcia-Patterson, A:
Hosp Santa Creu & Sant Pau, Inst Recerca, Barcelona, Spain
Adelantado, JM:
Hosp Santa Creu & Sant Pau, Dept Gynecol & Obstet, Barcelona, Spain
Medina, C:
Hosp Santa Creu & Sant Pau, Dept Gynecol & Obstet, Barcelona, Spain
Espinos, JJ:
Hosp Santa Creu & Sant Pau, Dept Gynecol & Obstet, Barcelona, Spain
Lopez, E:
Hosp Santa Creu & Sant Pau, Dept Pediat, Barcelona, Spain
Webb, SM:
ISCIII, Ctr Invest Biomed Red Enfermedades Raras CIBERER, Unidad 747, Barcelona, Spain
Univ Autonoma Barcelona, Dept Med, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Inst Recerca, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr, Barcelona, Spain
Corcoy, R:
ISCIII, Ctr Invest Biomed Red Bioingn Biomat & Nanomed CI, Madrid, Spain
Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr, Barcelona, Spain
Univ Autonoma Barcelona, Dept Med, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Inst Recerca, Barcelona, Spain
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