Haemorrhage into the anterior pituitary during pregnancy after induction of ovulation with clomiphene

A 34-year-old woman with secondary amenorrhoea and primary infertility became pregnant after treatment with clomiphene. She developed pre-eclampsia. Visual symptoms were experienced due to rapid enlargement of the anterior pituitary gland. The patient was delivered by Caesarean section. At subsequent craniotomy the patient was found to have haemorrhage into the pituitary gland, but histological examination of the pituitary tissue which was removed revealed no tumour tissue. One year after delivery the patient was still amenorrhoeic and had galactorrhoea with hyperprolactinaemia indicating that she probably had a small pituitary adenoma which was incompletely removed during neurosurgery.