Prior lesion: Prolactinoma |
|
|
|
|
|
|
|
Tandon et al.3737 Tandon A, Alzate J, LaSala P, Fried MP. Endoscopic endonasal transsphenoidal resection for pituitary apoplexy during the third trimester of pregnancy. Surg Res Pract. 2014;2014:397131
|
27 |
Headache, Visual defects |
36WG |
MRI: suprasellar, hemorrhagic mass with optic chiasm compression |
Endoscopic endonasal transsphenoidal resection (36WG) |
Resolution |
C-section at term |
Castro et al.2626 Melo Castro D, Mendes A, Pinto C, Gonçalves J, Braga J. Pituitary apoplexy during pregnancy – two cases reports. Acta Obstet Ginecol Port. 2015;9(03):267–270 -Case 2 |
32 |
Headache, nausea vomiting |
28WG |
MRI: intrapituitary hemorrhage |
Steroids |
Improvement |
C-section at term |
Prior lesion: Macroprolactinoma |
|
|
|
|
|
|
|
Freeman et al.88 Freeman R, Wezenter B, Silverstein M, et al. Pregnancy-associated subacute hemorrhage into a prolactinoma resulting in diabetes insipidus. Fertil Steril. 1992;58(02):427–429
|
22 |
Headaches, diaphoresis, Visual defects, Dl |
32WG |
MRI: pituitary hemorrhage, with optic chiasm compression and without neurohypophysis visualization |
BCP stopped when pregnancy was diagnosed Transsphenoidal evacuation |
Resolution |
Delivery at term |
Parihar et al.3434 Parihar V, Yadav YR, Sharma D. Pituitary apoplexy in a pregnant woman. Ann Indian Acad Neurol. 2009;12(01):54–55
|
22 |
Headache, vomiting, vision loss |
20WG |
Pituitary apoplexy and compression over optic nerve and chiasm |
BCP stopped when pregnancy was diagnosed Transsphenoidal decompression, removal of hematoma |
Resolution |
Delivery at term |
Grand'Maison S et al.1515 Grand’Maison S, Weber F, Bédard MJ, Mahone M, Godbout A. Pituitary apoplexy in pregnancy: A case series and literature review. Obstet Med. 2015;8(04):177–183 -Case 2 |
30 |
Headache |
20WG |
MRI: pituitary mass with acute bleeding |
Continued CBG (initiated before pregnancy) |
Resolution |
Vaginal delivery at term |
Jemel M et al.2020 Jemel M, Kandara H, Riahi M, Gharbi R, Nagi S, Kamoun I. Gestational pituitary apoplexy: Case series and review of the literature. J Gynecol Obstet Hum Reprod. 2019;48(10):873–881 -Case 2 |
35 |
Severe headache, nausea, vomiting deterioration of the visual field |
22WG |
MRI: a pituitary mass of compatible with a pituitary adenoma in apoplexy |
CBG initiated before pregnancy Microsurgical transsphenoidal |
|
Delivery at term |
Oguz et al.3131 Oguz S, et al. A case of atypical macroprolactinoma presenting with pituitary apoplexy during pregnancy and review of the literature. Gynecol Endocrinol. 2019
|
26 |
Headache, nausea, visual defects, left temporal deficit |
22WG |
MRI: macroadenoma with hemorrhage and optic chiasm compression |
CBG Transsphenoidal surgery |
Improvement |
C-section at term |
Witek et al.3838 Witek P, Zieliński G, Maksymowicz M, Zgliczyński W. Trans-sphenoidal surgery for a life-threatening prolactinoma apoplexy during pregnancy. Neuroendocrinol Lett. 2012;33(05):483–488
|
25 |
Headaches, dizziness, Visual defects |
14WG |
MRI: tumor enlargement with optic chiasm displacement and focal hemorrhage |
BCP stopped when pregnancy was diagnosed Restarted BCP Transsphenoidal adenomectomy (20WG) |
Improvement |
C-section at term |
Gondim et al.1313 Gondim J, Ramos Júnior F, Pinheiro I, Schops M, Tella Júnior OI. Minimally invasive pituitary surgery in a hemorrhagic necrosis of adenoma during pregnancy. Minim Invasive Neurosurg. 2003;46 (03):173–176
|
29 |
Headache, visual defects |
30WG |
MRI: Macroadenoma with inside hemorrhage |
Continued BCP (initiated before pregnancy)
Mini-invasive pituitary surgery (32WG)
|
|
Delivery at term |
Janssen et al.1919 Janssen NM, Dreyer K, van der Weiden RM. Management of pituitary tumour apoplexy with bromocriptine in pregnancy. JRSM Short Rep. 2012;3(06):43
|
27 |
Headache, visual defects |
10WG |
MRI: tumor growth, suprasellar extension and optic chiasm compression. Liquefaction within the tumor, indicating apoplexy |
BCP stopped when pregnancy was diagnosed Restarted BCP |
Resolution |
Vaginal delivery at term |
Hayes et al.1717 Hayes AR, O’Sullivan AJ, Davies MA. Endocrinol Diabetes Metab Case Rep. 2014
|
41 |
Visual defects |
18WG |
MRI: pituitary hemorrhage with a significant increase in the size of the tumor |
CBG stopped when pregnancy was diagnosed Stereotactic endoscopic transsphenoidal excision (2nd trimester) |
|
Vaginal delivery at term |
Couture et al.66 Couture N, Aris-Jilwan N, Serri O. Microprolactinoma apoplexy in pregnancy, Endocrine Practice Vol 18,. 2012
|
37 |
Headache, Nausea, Visual defects |
16WG |
MRI: sellar mass with suprasellar extension and contact with the optic chiasm, compatible with hemorrhage in a pituitary tumor |
BCP switched to CBG when pregnancy was diagnosed |
Resolution |
C-section at term |
Prior lesion: GHoma Lunardi et al.2424 Lunardi P, Rizzo A, Missori P, Fraioli B. Pituitary apoplexy in an acromegalic woman operated on during pregnancy by transphenoidal approach. Int J Gynaecol Obstet. 1991;34(01): 71–74
|
21 |
Headache, Visual defects |
24WG |
CT: intrasellar space-occupying lesion with a marked suprasellar extension. |
Transsphenoidal approach |
Resolution; Dl development |
Normal delivery at term |
Atmaca et al.33 Atmaca A, Dagdelen S, Erbas T. Follow-up of pregnancy in acromegalic women: different presentations and outcomes. Exp Clin Endocrinol Diabetes. 2006;114(03):135–139
|
33 |
Headache, Visual defects |
33WG |
MRI: Pituitary apoplexy |
Transsphenoidal resection during labor |
|
C-section at term |
Prior lesion: ACTHoma (Nelson syndrome) |
Gheorghiu et al.1212 Gheorghiu ML, Chirita C, Coculescu M. Partial remission of Nelson’s syndrome after pituitary apoplexy during pregnancy. Endocrin Abstr. 2009;19:191
|
33 |
Headache, nausea |
22WG |
MRI: intrasellar mass suggesting pituitary apoplexy |
|
Dl development |
Delivery at term |
Prior lesion: Adenoma Ohtsubo et al.3232 Ohtsubo T, Asakura T, Kadota K, et al. [A report of a trans-sphenoidal operation during pregnancy for a pituitary adenoma]. No Shinkei Geka. 1991;19(09):867–870
|
29 |
Headache, vomiting, Visual defects |
24WG |
CT and MRI: pituitary adenoma with hematoma |
Transsphenoidal approach (32WG) |
|
Delivery at term |
Prior lesion: Macroadenoma luliano et al.1818 Iuliano S, Laws ER Jr. Management of pituitary tumors in pregnancy. Semin Neurol. 2011;31(04):423–428
|
28 |
Headache, edema of the right optic disk |
29WG |
MRI: pituitary macroadenoma with hemorrhage and compression of the right optic nerve |
BCP Transnasal approach (29WG) |
Resolution |
Delivery at term |
Unknown prior lesion Murao et al. [3030 Murao K, Imachi H, Muraoka T, Ishida T. Hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome with pituitary apoplexy. Fertil Steril. 2011;96(01):260–261] |
35 |
Nausea, vomiting |
39WG |
MRI: pituitary apoplexy |
|
|
|
Kita et al.2121 Kita D, Hayashi Y, Sano H, et al. Postoperative diabetes insipidus associated with pituitary apoplexy during pregnancy. Neuroendocrinol Lett. 2012;33(02):107–112
|
26 |
Visual defects |
26WG |
MRI: pituitary mass with a fluid level component displacing the optic chiasm |
Endonasal endoscopic surgery (27WG) |
Improvement; Dl development |
Delivery at term |
Krull et al.22 Al-Sharafi BA, Nassar OH. Successful pregnancy in a female with a large prolactinoma after pituitary tumor apoplexy. Case Rep Obstet Gynecol. 2013;2013:817603
|
28 |
Headache, DI |
7WG |
MRI: pituitary apoplexy |
|
|
|
Piantanida et al.3535 Piantanida E, Gallo D, Lombardi V, et al. Pituitary apoplexy during pregnancy: a rare, but dangerous headache. J Endocrinol Invest. 2014;37(09):789–797
|
27 |
Headache, Visual defects |
35WG |
MRI: sellar mass with suprasellar extension, with optic chiasm compression, deviation of the pituitary stalk, and with recent bleeding |
Endonasal endoscopic transsphenoidal surgery, (postpartum) |
Resolution |
C-section at 35WG |
Fujimaki et al.99 Fujimaki T, Hotta S, Mochizuki T, et al. Pituitary apoplexy as a consequence of lymphocytic adenohypophysitis in a pregnant woman: a case report. Neurol Res. 2005;27(04):399–402
|
23 |
Headache, Visual defects |
24WG |
MRI: large mass occupying the pituitary fossa and suprasellar cistern |
Surgery was performed 1 month postpartum |
Improvement |
C-section at 34WG |
De Heide et al.77 de Heide LJM, van Tol KM, Doorenbos B. Pituitary apoplexy presenting during pregnancy. Neth J Med. 2004;62(10):393–396
|
26 |
Headache nausea, vomiting, Visual defects, DI |
23WG |
MRI: pituitary tumor with hemorrhage |
|
Improvement |
Delivery at term |
Bamfo et al.44 Bamfo JE, Sharif S, Donnelly T, Cohen MA, Golara M. A case of pituitary apoplexy masquerading as hyperemesis gravidarum. J Obstet Gynaecol. 2011;31(07):662
|
31 |
Vomiting, Visual defects, Unilateral ptosis |
10WG |
Hemorrhage into a preexisting solid or cystic lesion, with extension into the left cavernous sinus and optic chiasm compression |
|
|
C-section at term |
Lee et al.2323 Lee MS, Pless M. Apoplectic lymphocytic hypophysitis. Case report. J Neurosurg. 2003;98(01):183–185
|
26 |
Headache, visual defects, low TSH and FSH and high T4, prolactin and somatomedin C |
24WG |
MRI: mass arising from the pituitary fossa and extending into the suprasellar cistern compressing the optic chiasm |
Transsphenoidal surgery |
Resolution |
Vaginal delivery at term |
Grand'Maison S et al.1515 Grand’Maison S, Weber F, Bédard MJ, Mahone M, Godbout A. Pituitary apoplexy in pregnancy: A case series and literature review. Obstet Med. 2015;8(04):177–183 -Case 1 |
33 |
Headache, Visual defects, dizziness, neck stiffness |
39WG |
MRI/CT: sellar central hemorrhagic infarction and pituitary hyperplasia in contact with the optic chiasm |
|
|
Labor induction at term |
Abraham RR et al.11 Abraham RR, Pollitzer RE, Gokden M, Goulden PA. Spontaneous pituitary apoplexy during the second trimester of pregnancy, with sensory loss. BMJ Case Rep. 2016;2016:bcr2015212405. Doi: 10.1136/bcr-2015-212405 https://doi.org/10.1136/bcr-2015-212405...
|
32 |
Visual Defects decreased right V1-V2 facial |
23WG |
MRI: enlargement of the pituitary with hemorrhage and optic nerve compression |
Emergent endoscopic endonasal surgery (23WG) |
|
|
Jemel M et al.2020 Jemel M, Kandara H, Riahi M, Gharbi R, Nagi S, Kamoun I. Gestational pituitary apoplexy: Case series and review of the literature. J Gynecol Obstet Hum Reprod. 2019;48(10):873–881 -Case 1 |
32 |
Headache, Visual defects |
37WG |
MRI: sellar central hemorrhagic infarction and pituitary hyperplasia, compatible with sub- acute pituitary apoplexy |
None |
|
Labor induction at term |
Jemel M et al.2020 Jemel M, Kandara H, Riahi M, Gharbi R, Nagi S, Kamoun I. Gestational pituitary apoplexy: Case series and review of the literature. J Gynecol Obstet Hum Reprod. 2019;48(10):873–881 -Case 3 |
30 |
Headache, Visual defects |
24WG |
MRI: bleeding within a macroadenoma |
Endoscopic transsphenoidal ressection (24WG) |
Improvement |
Delivery at term |
Castro et al.2626 Melo Castro D, Mendes A, Pinto C, Gonçalves J, Braga J. Pituitary apoplexy during pregnancy – two cases reports. Acta Obstet Ginecol Port. 2015;9(03):267–270 -Case 1 |
27 |
Headache, Visual defects |
24WG |
MRI: pituitary hemorrhage, with optic tract compression |
Transsphenoidal partial excision of pituitary gland |
Resolution; Dl development |
C-section at term |
Mathur et al.2525 Mathur D, Lim LF, Mathur M, Sng BL. Pituitary apoplexy with reversible cerebral vasoconstrictive syndrome after spinal anaesthesia for emergency caesarean section: an uncommon cause for postpartum headache. Anaesth Intensive Care. 2014;42(01): 99–105
|
34 |
Headache, neurological deficits, reversible vasoconstriction syndrome and stroke |
Puer- perium |
MRI: Pituitary apoplexy was diagnosed based on a pituitary hemorrhage |
Steroids Nimodipine plus lamotrigine for seizure prophylaxis |
Resolution |
Emergent c- section |
Okafor et al.3333 Okafor UV, Onwuekwe IO, Ezegwui HU. Management of pituitary adenoma with mass effect in pregnancy: a case report. Cases J. 2009;2:911
|
30 |
Headache, vomiting, protrusion of the right eye |
24WG |
CT scan: pituitary tumor with pressure effects, occluding the anterior horn of the left lateral ventricle. The other ventricles were dilated |
BCP |
Hypertension with encephalopathy, cardiac arrest and death |
Emergent G section at 34 + 5WG |
Chan et al.55 Chan JL, Gregory KD, Smithson SS, Naqvi M, Mamelak AN. Pituitary apoplexy associated with acute COVID-19 infection and pregnancy. Pituitary. 2020;23(06):716–720
|
28 |
Headache, Visual defect, hypogonadism, low TSH and high serum prolactin |
38WG |
MRI: pituitary tumor, with hemorrhage and hypophysis and optic chiasm compression |
Steroids Transsphenoidal surgery 2 days after delivery |
Improvement |
Forceps at term |
Galvão et al.1010 Galvão A, Gonçalves D, Moreira M, Inocêncio G, Silva C, Braga J. Prolactinoma and pregnancy – a series of cases including pituitary apoplexy. J Obstet Gynaecol. 2016 - Case 1 |
30 |
Consciousness loss, Headache, Visual defects |
28WG |
MRI: macroprolactinoma, with sellar and suprasellar hemorrhage |
None |
Resolution |
C-section at term |
Galvão et al.1010 Galvão A, Gonçalves D, Moreira M, Inocêncio G, Silva C, Braga J. Prolactinoma and pregnancy – a series of cases including pituitary apoplexy. J Obstet Gynaecol. 2016 -Case 2 |
25 |
Headache, Visual defects |
|
MRI: pituitary apoplexy |
Transsphenoidal adenomectomy (2nd trimester) |
Development of Hypothyroidism and Dl |
C-section at term |
Cokmez et al.1616 Cokmez H, Bayram C. Pituitary apoplexy developing during pregnancy: escape from the verge of death,. Clinical and Experiment Obstetrics and Gynecology, 2020
|
26 |
Headache, vomiting, Visual defects |
24 WG |
MRI: macroadenoma and bleeding |
Steroids Tumor excision was performed with craniotomy |
Improvement |
C-section at term |