Pituitary

, Volume 15, Issue 1, pp 59–63

Pregnancy and acromegaly: a review

  • Vicky Cheng
  • Charles Faiman
  • Laurence Kennedy
  • Fadi Khoury
  • Betul Hatipoglu
  • Robert Weil
  • Amir Hamrahian
Article

DOI: 10.1007/s11102-011-0330-3

Cite this article as:
Cheng, V., Faiman, C., Kennedy, L. et al. Pituitary (2012) 15: 59. doi:10.1007/s11102-011-0330-3

Abstract

To review the literature regarding the diagnosis and management of acromegaly during pregnancy. A systematic literature search was performed using MEDLINE including hand-searching reference lists from original articles. The diagnosis of acromegaly during pregnancy is made difficult due to the physiologic changes in pituitary GH secretion and IGF-1 production resulting from placental GH secretion and the inability of commercial assays to discriminate between pituitary and placental GH. Most patients with acromegaly during pregnancy do not have an increase in tumor size, metabolic complications are uncommon, and neonatal outcome is largely unaffected. IGF-1 levels tend to be stable in such patients possibly due to the high estrogen levels causing GH resistance. Dopamine agonists, somatostatin analogues, and a GH receptor antagonist have been reported to be safe during pregnancy. Patients with visual field defects should be considered for surgery, but in most cases this can be safely postponed until after delivery. Overall, pregnancy in acromegaly is uneventful and newborns unaffected. Dopamine agonists and somatostatin analogues have not been associated with major adverse effects to the fetus; however, more data are needed to validate their safety.

Keywords

Acromegaly Pregnancy Medical therapy Surgery 

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Vicky Cheng
    • 1
  • Charles Faiman
    • 1
  • Laurence Kennedy
    • 1
  • Fadi Khoury
    • 2
  • Betul Hatipoglu
    • 1
  • Robert Weil
    • 3
  • Amir Hamrahian
    • 1
  1. 1.Endocrinology and Metabolism InstituteCleveland ClinicClevelandUSA
  2. 2.Obstetric and Gynecology InstituteCleveland ClinicClevelandUSA
  3. 3.Neurological InstituteCleveland ClinicClevelandUSA

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