Pregnancy outcome in pituitary tumors

Objective To observe the maternal and perinatal outcome in pituitary tumor (macro- and micro-adenoma) during pregnancy. Methods A retrospective analysis of a total of 19 cases of pituitary tumor group 1 (10 macroadenoma), and group 2 (9 microadenoma), during pregnancy over last 3 years in our unit were evaluated for pregnancy outcome, comparing maternal and perinatal outcome in the two groups using statistical analysis (Chi square test and Fischer exact t test). Results The mean age was 27.1 years in group 1 (macroadenoma), 29.2 years in group, parity was 0.2 and 0.55, respectively, in the two groups. Mean pituitary size 14.85 cm 3 in group 1 and 0.22 cm 3 in group 2. While there was no significant difference in infertility, menstrual disorder in the two groups, galactorrhea, headache, seizures and blurring of vision were more common in macroadenoma group. More patients required medications (cabergoline/bromocriptine) in group 1 with significantly more women had worsening of their symptoms (raised intracranial tension, seizures) in group 1 than in group 2. Mean gestation and birthweight were better in group 2 (37.6 vs. 36.1 weeks and 2,849 vs. 2,401 g). While vaginal delivery could be achieved in 88.8% women in microadenoma group (group 2), 80% women required cesarean delivery in macroadenoma group (group 1), a highly significant difference ( P value 0.005), there were no perinatal death in any group. Conclusion Pituitary tumor during pregnancy if properly treated is associated with excellent maternal and perinatal outcome but macroadenoma is associated with lower gestation, birth weight and increased cesarean delivery rate.