Abstract
The diagnosis and treatment of pituitary disease in pregnancy represents a special
clinical challenge. Not least because there is very little data on the treatment of
pregnant patients with pituitary disorders. A selective search of the literature was
carried out with the aim of compiling evidence about the diagnosis and treatment of
pituitary disease in pregnancy. The search covered the databases PubMed/MEDLINE including
PubMed Central and also used the Livivo (ZB MED) search engine. Recent studies were
evaluated for recommendations about the care of pregnant patients with hormone-inactive
and hormone-active pituitary adenomas (prolactinoma, acromegaly and Cushingʼs disease),
pituitary insufficiency, pituitary apoplexy and hypophysitis. The most well-established
forms of treatment are for prolactinoma, due to the incidence of this disease and
its impact on fertility. When pregnancy has been confirmed, prolactinoma treatment
with dopamine agonists should be paused. Although microprolactinomas rarely increase
significantly in size after the administration of dopamine agonists is discontinued,
symptomatic tumor growth of macroprolactinomas can occur. In such cases, treatment
with dopamine agonists can be resumed. If the primary tumor is large and the risk
that it will continue to grow is high, it may be necessary to continue medical treatment
from the start of pregnancy. If one of the partners has a pituitary disorder, it is
often still possible for many couples to achieve their wish of having children if
they receive medical support to plan and the pregnancy is carefully monitored. Given
the complexity of pituitary disease, pregnant patients with pituitary disorders should
be cared for and treated by a multidisciplinary team in centers specializing in the
diagnosis and treatment of pituitary disease.
Key words
pituitary disease - pituitary tumor - pregnancy - fertility - diabetes insipidus
