Hypopituitarism and pregnancy : clinical characteristics, management and pregnancy outcome
Aulinas, Anna (Institut d'Investigació Biomèdica Sant Pau)
Stantonyonge, N. (Institut d'Investigació Biomèdica Sant Pau)
García-Patterson, Apolonia (Institut d'Investigació Biomèdica Sant Pau)
Adelantado, Juan M.. (Institut d'Investigació Biomèdica Sant Pau)
Medina, Carmen (Institut d'Investigació Biomèdica Sant Pau)
Espinós, Juan José (Institut d'Investigació Biomèdica Sant Pau)
López, E. (Institut d'Investigació Biomèdica Sant Pau)
Webb, S. M 1952- (Institut d'Investigació Biomèdica Sant Pau)
Corcoy i Pla, Rosa (Institut d'Investigació Biomèdica Sant Pau)

Data:	2021
Resum:	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.
Nota:	Altres ajuts: acords transformatius de la UAB
Nota:	Altres ajuts: Open Access Funding provided by Universitat Autonoma de Barcelona.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Hormone replacement therapy ; Hypopituitarism ; Outcome ; Pregnancy
Publicat a:	Pituitary, 2021 , ISSN 1573-7403

Podeu consultar les dades de recerca que acompanyen l'article: https://ddd.uab.cat/record/256748
DOI: 10.1007/s11102-021-01196-7
PMID: 34846622

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