Skip to main content
SpringerLink
Log in

Traitement de ľinsuffisance hypophysaire pendant la grossesse

  • Chapter
Pathologie hypophysaire et grossesse

  • 303 Accesses

Abtrait

Il n’est pas très fréquent de devoir traiter une insuffisance hypophysaire pendant une grossesse. En effet, les causes principales ďinsuffisance hypophysaire sont les macroadénomes hypophysaires et les séquelles de leur traitement chirurgical ou radiothérapique (1). Or, ľâge moyen du diagnostic de ces macroadénomes se situe autour de cinquante ans. Cependant ďautres causes ďinsuffisance hypophysaire touchent des femmes plus jeunes, voire des fillettes (craniopharyngiome, histiocytose X, radiothérapie cérébrale pour médulloblastome, gliome des voies optiques ou autres tumeurs du système nerveux central, méningiome, syndrome de Sheehan, hypophysite lymphocytaire). Ces jeunes patientes, comme toutes les jeunes femmes, envisagent toujours la possibilité ďune grossesse et la plupart ďentre elles auront le désir de réaliser ce projet. Leur grossesse impose naturellement au préalable un traitement de stimulation de ľovulation par gonadotrophines, ou plus rarement par pompe GnRH. Ľendocrinologue aura donc en principe largement le temps de se préparer à ľadaptation du traitement substitutif. Plus rarement, il pourra être pris de court par la survenue ďune insuffisance hypophysaire au cours ďune grossesse, chez une patiente qui avait au départ des fonctions hypophysaires normales. Il s’agit alors ďune pathologie hypophysaire apparue pendant la grossesse, ou précipitée par celle-ci: hypophysite lymphocytaire, méningiome du tubercule de la selle, voire nécrose hémorragique ďun macroadénome, dont la sécrétion avant la grossesse n’aurait pas empêché la survenue ďune ovulation.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Références

  1. Bates As, Van’t Hoff W, Jones PJ, Clayton RN (1996) The effect of hypopituitarism on life expectancy. J Clin Endocrinol Metab 3: 1169–72

    Article  Google Scholar 

  2. Haddow JE, Palomaki GE, Allan WC et al. (1999) Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. N Engl J Med 8: 549–55

    Article  Google Scholar 

  3. Mandel SJ, Larsen PR, Seely EW, Brent GA (1990) Increased need for thyroxine during pregnancy in women with primary hypothyroidism. N Engl J Med 2: 91–6

    Article  Google Scholar 

  4. Glinoer D, De Nayer P, Robyn C et al. (1993) Serum levels of intact human chorionic gonadotropin (HCG) and its free alpha and beta subunits, in relation to maternal thyroid stimulation during normal pregnancy. J Endocrinol Invest 11: 881–8

    Google Scholar 

  5. Alexander EK, Marqusee E, Lawrence J et al. (2004) Timing and magnitude of increases in levothyroxine requirements during pregnancy in women with hypothyroidism. N Engl J Med 3: 241–9

    Article  Google Scholar 

  6. Lindsay JR, Nieman LK (2005) The hypothalamic-pituitary-adrenal axis in pregnancy: challenges in disease detection and treatment. Endocr Rev 6: 775–99

    Article  CAS  Google Scholar 

  7. Arlt W (2006) Androgen therapy in women. Eur J Endocrinol 1: 1–11

    Article  CAS  Google Scholar 

  8. Daya S, Gunby J (2004) Luteal phase support in assisted reproduction cycles. Cochrane Database Syst Rev 3 CD004830

    Google Scholar 

  9. Anaes, Afssaps (2004) Stratégies de choix des méthodes contraceptives chez la femme. Options contraceptives dans diverses situations particulières. Post Partum http://afssaps.sante.fr/pdf/5/rbp/con reco/pdf29

  10. American Academy of Pediatrics Committee on Drugs Pediatrics (2001) Transfer of drugs and other chemicals into human milk. 108(3): 776–89

    Google Scholar 

  11. Diaz S, Jackanicz TM, Herreros C et al. (1985) Fertility regulation in nursing women: VIII. Progesterone plasma levels and contraceptive efficacy of a progesterone-releasing vaginal ring. Contraception 6: 603–22

    Article  Google Scholar 

  12. Nilsson S, Nygren KG, Johansson ED (1978) Transfer of estradiol to human milk. Am J Obstet Gynecol 6: 653–7

    Google Scholar 

  13. De Coopman J (1993) Breastfeeding after pituitary resection: support for a theory of autocrine control of milk supply? J Hum Lact 1: 35–40

    Article  Google Scholar 

  14. Kauppila A, Chatelain P, Kirkinen P et al. (1987) Isolated prolactin deficiency in a woman with puerperal alactogenesis. J Clin Endocrinol Metab 2: 309–12

    Google Scholar 

  15. Frankenne F, Scippo ML, Van Beeumen J (1990) Identification of placental human growth hormone as the growth hormone-V gene expression product. J Clin Endocrinol Metab 1: 15–8

    Google Scholar 

  16. de Zegher F, Vanderschueren-Lodeweyckx M, Spitz B (1990) Perinatal growth hormone (GH) physiology: effect of GH-releasing factor on maternal and fetal secretion of pituitary and placental GH. J Clin Endocrinol Metab 2: 520–2

    Google Scholar 

  17. Frankenne F, Closset J, Gomez F (1988) The physiology of growth hormones (GHs) in pregnant women and partial characterization of the placental GH variant. J Clin Endocrinol Metab 6: 1171–80

    Article  Google Scholar 

  18. Hall K, Enberg G, Hellem E et al. (1984) Somatomedin levels in pregnancy: longitudinal study in healthy subjects and patients with growth hormone deficiency. J Clin Endocrinol Metab 4: 587–94

    Google Scholar 

  19. Salle A, Klein M, Pascal-Vigneron V et al. (2000) Successful pregnancy and birth after sequential cotreatment with growth hormone and gonadotropins in a woman with panhypopituitarism: a new treatment protocol. Fertil Steril 6: 1248–50

    Article  Google Scholar 

  20. European and Australian Multicenter Study (1995) Cotreatment with growth hormone and gonadotropin for ovulation induction in hypogonadotropic patients: a prospective, randomized, placebo-controlled, dose-response study. Fertil Steril 64(5): 917–23

    Google Scholar 

  21. Wiren L, Boguszewski CL, Johannsson G (2002) Growth hormone (GH) replacement therapy in GH-deficient women during pregnancy. Clin Endocrinol (Oxf) 2: 235–9

    Article  Google Scholar 

  22. Muller J, Starup J, Christiansen JS et al. (1995) Growth hormone treatment during pregnancy in a growth hormone-deficient woman. Eur J Endocrinol 6: 727–9

    Article  Google Scholar 

  23. Curran AJ, Peacey SR, Shalet SM (1998) Is maternal growth hormone essential for a normal pregnancy? Eur J Endocrinol 1: 54–8

    Article  Google Scholar 

  24. Ray JG (1998) DDAVP use during pregnancy: an analysis of its safety for mother and child. Obstet Gynecol Surv 7: 450–5

    Article  Google Scholar 

  25. Overton CE, Davis CJ, West et al. (2002) High risk pregnancies in hypopituitary women. Hum Reprod 6: 1464–7

    Article  Google Scholar 

Download references

Authors
  1. O. Chabre
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2007 Springer-Verlag France

About this chapter

Cite this chapter

Chabre, O. (2007). Traitement de ľinsuffisance hypophysaire pendant la grossesse. In: Pathologie hypophysaire et grossesse. Springer, Paris. https://doi.org/10.1007/978-2-287-35572-1_3

Download citation

  • DOI: https://doi.org/10.1007/978-2-287-35572-1_3

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-287-35571-4

  • Online ISBN: 978-2-287-35572-1

Publish with us

Policies and ethics

Search

Navigation