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Gebelikte Hipofizer Hastalıklar ve Bakım

Year 2024, Volume: 5 Issue: 4, 182 - 192
https://doi.org/10.46871/eams.1525363

Abstract

Hipofiz bezi, salgıladığı hormonlar sayesinde vücut üzerinde oldukça ciddi etkilere neden olur. Hipofizer hastalıkların başlıcaları prolaktinoma, akromegali, lenfositik hipofizit, hipofiz yetmezliği (hipopituitarizm), Cushing Sendromu ve Sheehan’s Sendromudur. Bu hastalıklarda gebelik durumu nadir olarak görüldüğü için tanı koyma genellikle gebelik öncesi dönemde gerçekleşir. Gebelik öncesi dönemde görülen belirti ve bulgular eşliğinde kişiye hastalıklara özgü tanı testleri sayesinde kesin tanı konulmaktadır. Gebelikte hipofiz bezinde meydana gelen anatomik ve fizyolojik değişiklikler hipofizer hastalıkların tanılanmasında zorluklara sebep olmaktadır. Bu nedenle hipofizer hastalıklarda verilecek bakım, gebelik öncesi dönemden itibaren etkin şekilde gerçekleştirilmelidir. Bu hastalıklar hem anne hem de fetüs için ciddi komplikasyonlara neden olup multidisipliner bir bakım yaklaşımı gerekmektedir. Bakım veren multidisipliner ekipte büyük role sahip ebeler ve diğer sağlık profesyonelleri, hipofizer hastalıkların belirtilerine, tanı ve tedavi yöntemlerine hakim olup hastalığa özgü bireyselleştirilmiş bir bakım yönetimi gerçekleştirilmelidir.

References

  • 1. Urhan E, Karaca Z. Pregnancy and pituitary diseases. Endocrinology Research & Practice. 2024; 28: 2. https//doi.org/10.5152/erp.2024.23291.
  • 2. Bendarska-Czerwińska A, Zmarzły N, Morawiec E, Panfil A, Bryś K, Czarniecka J, Grabarek B. O. Endocrine disorders and fertility and pregnancy: An update. Frontiers in Endocrinology. 2023; 13: 970439. https://doi.org/10.3389/fendo.2022.970439.
  • 3. Lee JH, Torp DJ. Adrenal insufficiency in pregnancy: Physiology, diagnosis, management and areas for future research. Reviews in Endocrine and Metabolic Disorders. 2023; 24: 1: 57-69.
  • 4. Green D, Dineen R, O’Reilly MW, Sherlock M. Fertility and pregnancy in adrenal insufficiency. Endocrine Connections. 2024; 13: 2. https://doi.org/10.1530/EC-23-0088.
  • 5. Petersenn S, Fleseriu M, Casanueva FF, Giustina A, Biermasz N, Biller BM, Melmed S. Diagnosis and management of prolactin-secreting pituitary adenomas: a Pituitary Society international Consensus Statement. Nature Reviews Endocrinology. 2023; 19: 12: 722-740.
  • 6. De Oliveira Gamito MAP, Amaral NYB, Rodrigues CF, Ribeiro JM, Guerra S. Pituitary apoplexy in pregnancy: what do we know?. Revista Brasileira de Ginecologia e Obstetrícia/RBGO Gynecology and Obstetrics. 2023; 45: 05: 273-280. https://doi.org/10.1055/s-0043-1770128.
  • 7. Corn M, Nickell A, Lessard C, Jackson A. Pituitary apoplexy during pregnancy with transsphenoidal resection and intraoperative fetal monitoring: A case report. Case Reports in Women's Health. 2023; 39: e00543. https://doi.org/10.1016/j.crwh.2023.e00543.
  • 8. Iglesias P. Pituitary Apoplexy: An Updated Review. Journal of Clinical Medicine. 2024; 13: 9: 2508. https://doi.org/10.3390/jcm13092508.
  • 9. Reddy SSK., Goparaju P, Fleseriu M. Hypothalamic-Pituitary Disorders. In Atlas of Clinical Endocrinology and Metabolism. 2024; 124-146.
  • 10. Castinetti F, Albarel F, Amodru V, Cuny T, Dufour H, Graillon T, Brue. The risks of medical treatment of prolactinoma. In Annales d'Endocrinologie. 2021; 82: 1: 15-19. https://doi.org/10.1016/j.ando.2020.12.008.
  • 11. Chanson P, Maiter D. Prolactinoma. In the Pituitary. 2022; 495-543. Academic Press. https://doi.org/10.1016/B978-0-323-99899-4.00011-1.
  • 12. Inder WJ, Jang C. Treatment of prolactinoma. Medicina. 2022; 58: 8: 1095. https://doi.org/10.3390/medicina58081095.
  • 13. Meletli ÖK, Altınova A, Bolayır B, Karakuş R, Coşkun M, Yalçın MM, Toruner FS. Prevalence of Autoimmune Thyroiditis and Other Autoimmune Diseases in Relation to Serum BAFF/APRIL Levels in Prolactinoma Patients. Gazi Medical Journal. 2024; 35: 1. https://doi.org/10.4274/gmj.galenos.2023.3597.
  • 14. Balkan E, Kaydırak MM, Şahin NH. Pituitary Diseases and Nursing Care During Pregnancy. BANU Journal of Health Science and Research. 2022; 4: 3: 272-277. https://doi.org/10.46413/boneyusbad.1159056.
  • 15. Molitch ME. Prolactinoma in pregnancy. Best practice & research Clinical endocrinology & metabolism. 2011; 25: 6: 885-896. https://doi.org/10.1016/j.beem.2011.05.011.
  • 16. Auriemma RS, Pirchio R, Pivonello C, Garifalos F, Colao A, Pivonello R. Approach to the Patient with Prolactinoma. The Journal of Clinical Endocrinology & Metabolism. 2023; 108: 9: 2400-2423. https://doi.org/10.1210/clinem/dgad174.
  • 17. Ershadinia N, Tritos NA. Diagnosis and treatment of acromegaly: an update. In Mayo Clinic Proceedings. 2022; 97: 2: 333-346. https://doi.org/10.1016/j.mayocp.2021.11.007.
  • 18. Fleseriu M, Langlois F, Lim DST, Varlamov EV, Melmed S. Acromegaly: pathogenesis, diagnosis, and management. The Lancet Diabetes & Endocrinology. 2022; 10: 11: 804-826.
  • 19. Çağlayan K. Acromegaly. Turkiye Klinikleri Endocrinology-Special Topics. 2024; 17: 1: 24-33.
  • 20. Giustina A, Barkan A, Beckers A, Biermasz N, Biller BM, Boguszewski C, Melmed S. A consensus on the diagnosis and treatment of acromegaly comorbidities: an update. The Journal of Clinical Endocrinology & Metabolism. 2020; 105: 4: e937-e946. https://doi.org/10.1210/clinem/dgz096.
  • 21. Colao A, Pivonello C, Grasso LF, Pirchio R. Acromegaly. In Endocrine Pathology. 2022; 9-11. Cham: Springer International Publishing. https://doi.org/10.1007/978-3-030-62345-6.
  • 22. Stiles CE, Hossain B, Drake WM. Acromegaly. Medicine. 2021; 49: 8: 488-491. https://doi.org/10.1016/j.mpmed.2021.05.007.
  • 23. Giustina A, Barkan A, Beckers A, Biermasz N, Biller BM, Boguszewski C, Melmed S. A consensus on the diagnosis and treatment of acromegaly comorbidities: an update. The Journal of Clinical Endocrinology & Metabolism. 2020; 105: 4: e937-e946. https://doi.org/10.1210/clinem/dgz096.
  • 24. Kara M. Hypophysitis. Acıbadem University Health Sciences Journal. 2020; 4: 561-566. https://doi.org/10.31067/0.2019.191.
  • 25. Naran J, Can AS. Lymphocytic hypophysitis. Europe PMC. 2023; PMID: 32965926.
  • 26. Donegan D, Saeed Z, Delivanis DA, Murad M. H, Honegger J, Amereller F, Bancos I. Outcomes of initial management strategies in patients with autoimmune lymphocytic hypophysitis: a systematic review and meta-analysis. The Journal of Clinical Endocrinology & Metabolism. 2022; 107: 4: 1170-1190. https://doi.org/10.1210/clinem/dgab839.
  • 27. Khaleghi M, Finger G, Wu KC, Munjal V, Ghalib L, Kobalka P, Prevedello D. Successful treatment of medically and surgically refractory lymphocytic hypophysitis with fractionated stereotactic radiotherapy: a single-center experience and systematic literature review. Pituitary. 2024; 27; 213-229.
  • 28. Parkin K, Kapoor R, Bhat R, Greenough A. Genetic causes of hypopituitarism. Archives of Medical Science. 2020; 16: 1: 27-33. https://doi.org/10.5114/aoms.2020.91285.
  • 29. Gezer E, Cantürk Z. Pregnancy and Hypopituitarism. Turkiye Klinikleri Endocrinology-Special Topics. 2020; 13: 2: 20-24.
  • 30. Beysel S, Çalişkan M, Kizilgül M, Kan S, Özbek M, Çakal E. Clinical evaluation of pituitary insufficiency in adult population. Turkish Journal of Medical Sciences. 2020; 50:4: 917-921. https://doi.org/10.3906/sag-1908-19.
  • 31. Profka E, Rodari G, Giacchetti F, Giavoli C. GH deficiency and replacement therapy in hypopituitarism: insight into the relationships with other hypothalamic-pituitary axes. Frontiers in Endocrinology. 2021; 12: 678778. https://doi.org/10.3389/fendo.2021.678778.
  • 32. Reincke M, Fleseriu M. Cushing syndrome: a review. Jama. 2023; 330: 2: 170-181.https://doi.org/10.1001/jama.2023.11305.
  • 33. Karaca Z, Tanrıverdi F, Unluhizarci K, Kelestimur F. Pregnancy and pituitary disorders. European Journal of Endocrinology. 2010; 162:3: 453- 475. https://doi.org/10.1530/EJE-09-0923.
  • 34. Chrisoulidou A, Boudina M, Karavitaki N, Bili E, Wass J. Pituitary disorders in pregnancy. Hormones. 2015; 14:1: 70-80. https://doi.org/10.1007/BF03401382.
  • 35. Duman D, Işık A, Tarikoğulları İ, Ongun F, Evran M. Sheehan syndrome. Çukurova Medical Students' Journal. 2021; 1: 1: 28-31.
  • 36. Laway BA, Mir SA. Pregnancy and pituitary disorders: Challenges in diagnosis and management. Indian Journal of Endocrinology and Metabolism. 2013; 17; 6: 996-1004. doi: https://doi.org/10.4103/2230- 8210.122608.
  • 37. Valassi E. Pituitary disease and pregnancy. Endocrinología, Diabetes y Nutrición. 2021; 68: 3: 184- 195. https://doi.org/10.1016/j.endien.2020.07.002.
  • 38. Karaca Z, Kelestimur F. Sheehan Syndrome. In Pituitary Disorders throughout the Life Cycle: A Case-Based Guide. 2022; 217-228.

Pituitary Dıseases and Care in Pregnancy

Year 2024, Volume: 5 Issue: 4, 182 - 192
https://doi.org/10.46871/eams.1525363

Abstract

The pituitary gland causes very serious effects on the body thanks to the hormones it secretes. The main pituitary diseases are prolactinoma, acromegaly, lymphocytic hypophysitis, pituitary insufficiency (hypopituitarism), Cushing's syndrome and Sheehan's syndrome. Since pregnancy is rare in these diseases, the diagnosis is usually made in the pre-pregnancy period. A definitive diagnosis is made by means of disease-specific diagnostic tests accompanied by symptoms and findings seen in the pre-pregnancy period. Anatomical and physiological changes in the pituitary gland during pregnancy cause difficulties in the diagnosis of pituitary diseases. For this reason, the care to be given in pituitary diseases should be carried out effectively from the pre-pregnancy period. These diseases cause serious complications for both mother and foetus and require a multidisciplinary care approach. Midwives and other health professionals, who have a major role in the multidisciplinary team providing care, should be familiar with the symptoms, diagnosis and treatment methods of pituitary diseases and an individualised care management specific to the disease should be carried out.

References

  • 1. Urhan E, Karaca Z. Pregnancy and pituitary diseases. Endocrinology Research & Practice. 2024; 28: 2. https//doi.org/10.5152/erp.2024.23291.
  • 2. Bendarska-Czerwińska A, Zmarzły N, Morawiec E, Panfil A, Bryś K, Czarniecka J, Grabarek B. O. Endocrine disorders and fertility and pregnancy: An update. Frontiers in Endocrinology. 2023; 13: 970439. https://doi.org/10.3389/fendo.2022.970439.
  • 3. Lee JH, Torp DJ. Adrenal insufficiency in pregnancy: Physiology, diagnosis, management and areas for future research. Reviews in Endocrine and Metabolic Disorders. 2023; 24: 1: 57-69.
  • 4. Green D, Dineen R, O’Reilly MW, Sherlock M. Fertility and pregnancy in adrenal insufficiency. Endocrine Connections. 2024; 13: 2. https://doi.org/10.1530/EC-23-0088.
  • 5. Petersenn S, Fleseriu M, Casanueva FF, Giustina A, Biermasz N, Biller BM, Melmed S. Diagnosis and management of prolactin-secreting pituitary adenomas: a Pituitary Society international Consensus Statement. Nature Reviews Endocrinology. 2023; 19: 12: 722-740.
  • 6. De Oliveira Gamito MAP, Amaral NYB, Rodrigues CF, Ribeiro JM, Guerra S. Pituitary apoplexy in pregnancy: what do we know?. Revista Brasileira de Ginecologia e Obstetrícia/RBGO Gynecology and Obstetrics. 2023; 45: 05: 273-280. https://doi.org/10.1055/s-0043-1770128.
  • 7. Corn M, Nickell A, Lessard C, Jackson A. Pituitary apoplexy during pregnancy with transsphenoidal resection and intraoperative fetal monitoring: A case report. Case Reports in Women's Health. 2023; 39: e00543. https://doi.org/10.1016/j.crwh.2023.e00543.
  • 8. Iglesias P. Pituitary Apoplexy: An Updated Review. Journal of Clinical Medicine. 2024; 13: 9: 2508. https://doi.org/10.3390/jcm13092508.
  • 9. Reddy SSK., Goparaju P, Fleseriu M. Hypothalamic-Pituitary Disorders. In Atlas of Clinical Endocrinology and Metabolism. 2024; 124-146.
  • 10. Castinetti F, Albarel F, Amodru V, Cuny T, Dufour H, Graillon T, Brue. The risks of medical treatment of prolactinoma. In Annales d'Endocrinologie. 2021; 82: 1: 15-19. https://doi.org/10.1016/j.ando.2020.12.008.
  • 11. Chanson P, Maiter D. Prolactinoma. In the Pituitary. 2022; 495-543. Academic Press. https://doi.org/10.1016/B978-0-323-99899-4.00011-1.
  • 12. Inder WJ, Jang C. Treatment of prolactinoma. Medicina. 2022; 58: 8: 1095. https://doi.org/10.3390/medicina58081095.
  • 13. Meletli ÖK, Altınova A, Bolayır B, Karakuş R, Coşkun M, Yalçın MM, Toruner FS. Prevalence of Autoimmune Thyroiditis and Other Autoimmune Diseases in Relation to Serum BAFF/APRIL Levels in Prolactinoma Patients. Gazi Medical Journal. 2024; 35: 1. https://doi.org/10.4274/gmj.galenos.2023.3597.
  • 14. Balkan E, Kaydırak MM, Şahin NH. Pituitary Diseases and Nursing Care During Pregnancy. BANU Journal of Health Science and Research. 2022; 4: 3: 272-277. https://doi.org/10.46413/boneyusbad.1159056.
  • 15. Molitch ME. Prolactinoma in pregnancy. Best practice & research Clinical endocrinology & metabolism. 2011; 25: 6: 885-896. https://doi.org/10.1016/j.beem.2011.05.011.
  • 16. Auriemma RS, Pirchio R, Pivonello C, Garifalos F, Colao A, Pivonello R. Approach to the Patient with Prolactinoma. The Journal of Clinical Endocrinology & Metabolism. 2023; 108: 9: 2400-2423. https://doi.org/10.1210/clinem/dgad174.
  • 17. Ershadinia N, Tritos NA. Diagnosis and treatment of acromegaly: an update. In Mayo Clinic Proceedings. 2022; 97: 2: 333-346. https://doi.org/10.1016/j.mayocp.2021.11.007.
  • 18. Fleseriu M, Langlois F, Lim DST, Varlamov EV, Melmed S. Acromegaly: pathogenesis, diagnosis, and management. The Lancet Diabetes & Endocrinology. 2022; 10: 11: 804-826.
  • 19. Çağlayan K. Acromegaly. Turkiye Klinikleri Endocrinology-Special Topics. 2024; 17: 1: 24-33.
  • 20. Giustina A, Barkan A, Beckers A, Biermasz N, Biller BM, Boguszewski C, Melmed S. A consensus on the diagnosis and treatment of acromegaly comorbidities: an update. The Journal of Clinical Endocrinology & Metabolism. 2020; 105: 4: e937-e946. https://doi.org/10.1210/clinem/dgz096.
  • 21. Colao A, Pivonello C, Grasso LF, Pirchio R. Acromegaly. In Endocrine Pathology. 2022; 9-11. Cham: Springer International Publishing. https://doi.org/10.1007/978-3-030-62345-6.
  • 22. Stiles CE, Hossain B, Drake WM. Acromegaly. Medicine. 2021; 49: 8: 488-491. https://doi.org/10.1016/j.mpmed.2021.05.007.
  • 23. Giustina A, Barkan A, Beckers A, Biermasz N, Biller BM, Boguszewski C, Melmed S. A consensus on the diagnosis and treatment of acromegaly comorbidities: an update. The Journal of Clinical Endocrinology & Metabolism. 2020; 105: 4: e937-e946. https://doi.org/10.1210/clinem/dgz096.
  • 24. Kara M. Hypophysitis. Acıbadem University Health Sciences Journal. 2020; 4: 561-566. https://doi.org/10.31067/0.2019.191.
  • 25. Naran J, Can AS. Lymphocytic hypophysitis. Europe PMC. 2023; PMID: 32965926.
  • 26. Donegan D, Saeed Z, Delivanis DA, Murad M. H, Honegger J, Amereller F, Bancos I. Outcomes of initial management strategies in patients with autoimmune lymphocytic hypophysitis: a systematic review and meta-analysis. The Journal of Clinical Endocrinology & Metabolism. 2022; 107: 4: 1170-1190. https://doi.org/10.1210/clinem/dgab839.
  • 27. Khaleghi M, Finger G, Wu KC, Munjal V, Ghalib L, Kobalka P, Prevedello D. Successful treatment of medically and surgically refractory lymphocytic hypophysitis with fractionated stereotactic radiotherapy: a single-center experience and systematic literature review. Pituitary. 2024; 27; 213-229.
  • 28. Parkin K, Kapoor R, Bhat R, Greenough A. Genetic causes of hypopituitarism. Archives of Medical Science. 2020; 16: 1: 27-33. https://doi.org/10.5114/aoms.2020.91285.
  • 29. Gezer E, Cantürk Z. Pregnancy and Hypopituitarism. Turkiye Klinikleri Endocrinology-Special Topics. 2020; 13: 2: 20-24.
  • 30. Beysel S, Çalişkan M, Kizilgül M, Kan S, Özbek M, Çakal E. Clinical evaluation of pituitary insufficiency in adult population. Turkish Journal of Medical Sciences. 2020; 50:4: 917-921. https://doi.org/10.3906/sag-1908-19.
  • 31. Profka E, Rodari G, Giacchetti F, Giavoli C. GH deficiency and replacement therapy in hypopituitarism: insight into the relationships with other hypothalamic-pituitary axes. Frontiers in Endocrinology. 2021; 12: 678778. https://doi.org/10.3389/fendo.2021.678778.
  • 32. Reincke M, Fleseriu M. Cushing syndrome: a review. Jama. 2023; 330: 2: 170-181.https://doi.org/10.1001/jama.2023.11305.
  • 33. Karaca Z, Tanrıverdi F, Unluhizarci K, Kelestimur F. Pregnancy and pituitary disorders. European Journal of Endocrinology. 2010; 162:3: 453- 475. https://doi.org/10.1530/EJE-09-0923.
  • 34. Chrisoulidou A, Boudina M, Karavitaki N, Bili E, Wass J. Pituitary disorders in pregnancy. Hormones. 2015; 14:1: 70-80. https://doi.org/10.1007/BF03401382.
  • 35. Duman D, Işık A, Tarikoğulları İ, Ongun F, Evran M. Sheehan syndrome. Çukurova Medical Students' Journal. 2021; 1: 1: 28-31.
  • 36. Laway BA, Mir SA. Pregnancy and pituitary disorders: Challenges in diagnosis and management. Indian Journal of Endocrinology and Metabolism. 2013; 17; 6: 996-1004. doi: https://doi.org/10.4103/2230- 8210.122608.
  • 37. Valassi E. Pituitary disease and pregnancy. Endocrinología, Diabetes y Nutrición. 2021; 68: 3: 184- 195. https://doi.org/10.1016/j.endien.2020.07.002.
  • 38. Karaca Z, Kelestimur F. Sheehan Syndrome. In Pituitary Disorders throughout the Life Cycle: A Case-Based Guide. 2022; 217-228.
There are 38 citations in total.

Details

Primary Language English
Subjects Obstetrics and Gynaecology
Journal Section Review
Authors

Elif Bayrakçı 0000-0001-6351-6002

Ayse Elkoca 0000-0002-3936-4122

Early Pub Date November 25, 2024
Publication Date
Submission Date July 31, 2024
Acceptance Date September 17, 2024
Published in Issue Year 2024 Volume: 5 Issue: 4

Cite

Vancouver Bayrakçı E, Elkoca A. Pituitary Dıseases and Care in Pregnancy. Exp Appl Med Sci. 2024;5(4):182-9.

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