ESE Clinical Practice Guideline on functioning and nonfunctioning pituitary adenomas in pregnancy

Pregnancies are rare in women with pituitary adenomas, which may relate to hormone excess from secretory subtypes such as prolactinomas or corticotroph adenomas. Decreased fertility also result deficiencies due compression of the gland by large tumours and/or surgical radiation treatment lesion. Counselling premenopausal adenomas about their chance conceiving spontaneously assisted reproductive technology, and optimal pre-conception treatment, should start at time initial diagnosis. The normal physiological changes during pregnancy need be considered when interpreting endocrine tests Dose adjustments substitution therapies needed across trimesters. When medical therapy is used for excess, consideration given known efficacy safety data specific pregnant each therapeutic option. In healthy women, size increases pregnancy. Since some enlarge pregnancy, there a risk visual impairment, especially macroadenomas near optic chiasm. Pituitary apoplexy represents acute complication requiring surveillance, intervention cases. This guideline describes choice timing diagnostic treatments stage until after delivery, taking into account adenoma size, location activity. most cases, managed multidisciplinary team centre specialised tumours.