Acromegaly in pregnant women is an uncommon clinical problem. However, today, due to earlier diagnosis, women present with this concern at a younger age. In patients with pre-existing acromegaly, there may be difficulty conceiving, there are concerns regarding maternal and fetal outcomes, and there are no good data to fully assess the risk:benefit ratio of the various therapies that could be used during pregnancy. Acromegaly diagnosed for the first time during pregnancy is another clinical problem.
Acromegaly in pregnant women is an uncommon clinical problem. However, today, due to earlier diagnosis, women present with this concern at a younger age. In patients with pre-existing acromegaly, there may be difficulty conceiving, there are concerns regarding maternal and fetal outcomes, and there are no good data to fully assess the risk:benefit ratio of the various therapies that could be used during pregnancy. Acromegaly diagnosed for the first time during pregnancy is another clinical problem.
Acromegaly is a rare disease with an annual incidence of three to four per million people,1 characterized by excessive production of growth hormone (GH) from somatotroph cells in the pituitary gland, almost always from an adenoma. Acromegaly in pregnancy is even more rare and limited data are available, mainly as a consequence of the reduced fertility often found in women with pre-existing pituitary disease.
Pituitary Changes in Normal Pregnancy
Magnetic resonance imaging (MRI) scans performed during pregnancy demonstrate a gradual increase in maternal pituitary volume over the course of gestation, with an increased final weight (660–760 mg) as well as a volume increase of 30 % above the pre-gestational volume.2,3 This enlargement results in a homogeneous upward convexity of the superior surface of the gland when visualized radiologically, and the gland reaches 12 mm in height a few days post-partum. It usually does not increase more than 2.6 mm. The pituitary gland increases in all dimensions, with an average increase of 136 %.2
To view the full article in PDF or eBook formats, please click on the icons above.
