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中华妇幼临床医学杂志(电子版) ›› 2023, Vol. 19 ›› Issue (04) : 487 -491. doi: 10.3877/cma.j.issn.1673-5250.2023.04.015

综述

垂体瘤孕妇的诊治与围分娩期管理
冉晨曦, 沈如飞, 廖明钰, 廖倩, 周玲, 张玉玲, 隆敏()   
  1. 中国人民解放军陆军军医大学第二附属医院内分泌科,重庆 400037
    中国人民解放军陆军军医大学第一附属医院内分泌科,重庆 400037
  • 收稿日期:2023-03-25 修回日期:2023-06-23 出版日期:2023-08-01
  • 通信作者: 隆敏

Treatment and management of pituitary tumor during pregnancy

Chenxi Ran, Rufei Shen, Mingyu Liao, Qian Liao, Ling Zhou, Yuling Zhang, Min Long()   

  1. Department of Endocrinology, The Second Affiliated Hospital (Xinqiao Hospital) of Army Medical University, Chongqing 400037, China
    Department of Endocrinology, The First Affiliated Hospital (Xinan Hospital) of Army Medical University, Chongqing 400037, China
  • Received:2023-03-25 Revised:2023-06-23 Published:2023-08-01
  • Corresponding author: Min Long
  • Supported by:
    Chongqing Young and Middle-aged Medical Talents Project(20220505)
引用本文:

冉晨曦, 沈如飞, 廖明钰, 廖倩, 周玲, 张玉玲, 隆敏. 垂体瘤孕妇的诊治与围分娩期管理[J/OL]. 中华妇幼临床医学杂志(电子版), 2023, 19(04): 487-491.

Chenxi Ran, Rufei Shen, Mingyu Liao, Qian Liao, Ling Zhou, Yuling Zhang, Min Long. Treatment and management of pituitary tumor during pregnancy[J/OL]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(04): 487-491.

女性孕期激素水平会发生显著变化,垂体正常组织和垂体瘤组织均易受激素水平改变的影响。对于垂体瘤女性患者,孕期垂体激素水平变化,除了增加肿瘤生长风险外,还会影响孕妇和胎儿健康;对垂体瘤孕妇采取不同的治疗或干预手段,均可影响其整个孕期的自然进程。由于妊娠状态的特殊性,使得孕期对垂体瘤的诊断颇具挑战性,由垂体激素水平(催乳素、生长激素、皮质醇等)异常继发的不良妊娠结局亦可能增加。因此,孕期垂体瘤的诊治及随访十分重要。本文重点分析各型垂体瘤患者的孕期特点和注意事项,旨在为这类患者孕期个体化管理提供指导。

During pregnancy, there will be significant changes in endogenous hormones level, and pituitary tissues are susceptible to these changes. For women with pituitary tumor, changes in pituitary hormones during pregnancy will not only increase the risk of tumor growth, but also affect the health status of them and their fetuses. Different treatments or interventions during pregnancy can also affect the natural course of pregnancy in patients with pituitary tumors. The specificity of pregnancy status makes the diagnosis of pituitary tumors during pregnancy challenging, which leads to an increase in adverse pregnancy outcomes secondary to abnormal pituitary hormone levels such as prolactin, growth hormone, cortisol, etc.. Therefore, the diagnosis, treatments and follow-up of pituitary tumors during pregnancy are very important. This article focuses on analyzing the pregnancy characteristics and precautions of patients with various types of pituitary tumors, in order to provide guidance for the individualized management of such patients during pregnancy.

[1]
Luger A, Broersen LA, Biermasz NR, et al. ESE Clinical Practice Guideline on functioning and nonfunctioning pituitary adenomas in pregnancy[J]. Eur J Endocrinol, 2021, 185(3): G1-G33. DOI: 10.1530/EJE-21-0462.
[2]
Asa SL, Mete O, Perry A, et al. Overview of the 2022 WHO classification of pituitary tumors[J]. Endocr Pathol, 2022, 33(1): 6-26. DOI: 10.1007/s12022-022-09703-7.
[3]
Valassi E. Pituitary disease and pregnancy[J]. Endocrinol Diabetes Nutr (Engl Ed), 2021, 68(3): 184-195. DOI: 10.1016/j.endien.2020.07.002.
[4]
Glezer A, Bronstein MD. Prolactinomas in pregnancy: considerations before conception and during pregnancy[J]. Pituitary, 2020, 23(1): 65-69. DOI: 10.1007/s11102-019-01010-5.
[5]
Kuhn E, Weinreich AA, Biermasz NR, et al. Apoplexy of microprolactinomas during pregnancy: report of five cases and review of the literature[J]. Eur J Endocrinol, 2021, 185(1): 99-108. DOI: 10.1530/EJE-21-0145.
[6]
Petersenn S. Management des prolaktinoms vor, während und nach der schwangerschaft [Management of prolactinoma prior to, during, and after pregnancy][J]. Dtsch Med Wochenschr, 2023, 148(7): 371-379. DOI: 10.1055/a-1847-2500.
[7]
Barraud S, Guédra L, Delemer B, et al. Evolution of macroprolactinomas during pregnancy: a cohort study of 85 pregnancies[J]. Clin Endocrinol (Oxf), 2020, 92(5): 421-427. DOI: 10.1111/cen.14162.
[8]
Levin G, Rottenstreich A. Prolactin, prolactin disorders, and dopamine agonists during pregnancy[J]. Hormones (Athens), 2019, 18(2): 137-139. DOI: 10.1007/s42000-018-0071-z.
[9]
Pasyechko N, Naumova L, Krytskyy T, et al. Successful treatment of a prolactinoma (case report)[J]. Georgian Med Issues, 2019(287): 26-29.
[10]
Sant′ Anna BG, Musolino NRC, Gadelha MR, et al. A Brazilian multicentre study evaluating pregnancies induced by cabergoline in patients harboring prolactinomas[J]. Pituitary, 2020, 23(2): 120-128. DOI: 10.1007/s11102-019-01008-z.
[11]
List EO, Berryman DE, List BP, et al. Early investigations of 20-kDa human placental GH show promise[J]. Endocr Metab Immune Disord Drug Targets, 2023 May 15. DOI: 10.2174/1871530323666230515153130. Online ahead of print.
[12]
Bandeira DB, Olivatti TOF, Bolfi F, et al. Acromegaly and pregnancy: a systematic review and Meta-analysis[J]. Pituitary, 2022, 25(3): 352-362. DOI: 10.1007/s11102-022-01208-0.
[13]
Vialon M, Grunenwald S, Mouly C, et al. Gestational diabetes and acromegaly: single-centre experience of 14 pregnancies[J]. Clin Endocrinol (Oxf), 2019, 91(6): 805-809. DOI: 10.1111/cen.14097.
[14]
Popescu AD, Carsote M, Valea A, et al. Approach of acromegaly during pregnancy[J]. Diagnostics (Basel), 2022, 12(11): 2669. DOI: 10.3390/diagnostics12112669.
[15]
Chanson P, Vialon M, Caron P. An update on clinical care for pregnant women with acromegaly[J]. Expert Rev Endocrinol Metab, 2019, 14(2): 85-96. DOI: 10.1080/17446651.2019.1571909.
[16]
Huang W, Molitch ME. Pituitary tumors in pregnancy[J]. Endocrinol Metab Clin North Am, 2019, 48(3): 569-581. DOI: 10.1016/j.ecl.2019.05.004.
[17]
Petersenn S, Christ-Crain M, Droste M, et al. Pituitary disease in pregnancy: special aspects of diagnosis and treatment?[J]. Geburtshilfe Frauenheilkd, 2019, 79(4): 365-374. DOI: 10.1055/a-0794-7587.
[18]
Jolly K, Darr A, Arlt W, et al. Surgery for Cushing′s disease in pregnancy: our experience and a literature review[J]. Ann R Coll Surg Engl, 2019, 101(1): e26-e31. DOI: 10.1308/rcsann.2018.0175.
[19]
Hamblin R, Coulden A, Fountas A, et al. The diagnosis and management of Cushing′s syndrome in pregnancy[J]. J Neuroendocrinol, 2022, 34(8): e13118. DOI: 10.1111/jne.13118.
[20]
Brue T, Amodru V, Castinetti F. Management of endocrine disease: management of Cushing′s syndrome during pregnancy: solved and unsolved questions[J]. Eur J Endocrinol, 2018, 178(6): R259-R266. DOI: 10.1530/EJE-17-1058.
[21]
Patel MA, Aliporewala VM, Patel DA. Common antifungal drugs in pregnancy: risks and precautions[J]. J Obstet Gynaecol India, 2021, 71(6): 577-582. DOI: 10.1007/s13224-021-01586-8.
[22]
Chaiamnuay S, Moster M, Katz MR, et al. Successful management of a pregnant woman with a TSH secreting pituitary adenoma with surgical and medical therapy[J]. Pituitary, 2003, 6(2): 109-113. DOI: 10.1023/b:pitu.0000004802.47010.00.
[23]
Woodmansee WW. Pituitary disorders in pregnancy[J]. Neurol Clin, 2019, 37(1): 63-83. DOI: 10.1016/j.ncl.2018.09.009.
[24]
Blackhurst G, Strachan MW, Collie D, et al. The treatment of a thyrotropin-secreting pituitary macroadenoma with octreotide in twin pregnancy[J]. Clin Endocrinol (Oxf), 2002, 57(3): 401-404. DOI: 10.1046/j.1365-2265.2002.01549.x.
[25]
Barsi á, Beke A, Sármán B. Case report: a particularly rare case of endogenous hyperinsulinemic hypoglycemia complicated with pregnancy treated with short-acting somatostatin analog injections[J]. Front Endocrinol (Lausanne), 2022, 13: 964481. DOI: 10.3389/fendo.2022.964481.
[26]
Deutschbein T, Jaursch-Hancke C, Knappe UJ, et al. First german guideline on diagnostics and therapy of clinically non-functioning pituitary tumors[J]. Exp Clin Endocrinol Diabetes, 2021, 129(3): 250-264. DOI: 10.1055/a-1373-4087.
[27]
Karaca Z, Yarman S, Ozbas I, et al. How does pregnancy affect the patients with pituitary adenomas: a study on 113 pregnancies from Turkey[J]. J Endocrinol Invest, 2018, 41(1): 129-141. DOI: 10.1007/s40618-017-0709-8.
[28]
Rosmino J, Tkatch J, Di Paolo MV, et al. Non-functioning pituitary adenomas and pregnancy: one-center experience and review of the literature[J]. Arch Endocrinol Metab, 2021, 64(5): 614-622. DOI: 10.20945/2359-3997000000232.
[29]
Flitsch J, Burkhardt T. Non-functioning pituitary tumors: any special considerations during pregnancy?[J]. Minerva Endocrinol, 2018, 43(4): 430-434. DOI: 10.23736/s0391-1977.17.02784-5.
[30]
Noyola-Martínez N, Halhali A, Barrera D. Steroid hormones and pregnancy[J]. Gynecol Endocrinol, 2019, 35(5): 376-384. DOI: 10.1080/09513590.2018.1564742.
[31]
Gersh FL, Lavie CJ. Details on hormone replacement therapy[J]. Heart, 2020, 106(16): 1278-1279. DOI: 10.1136/heartjnl-2020-317044.
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