Pituitary tumors during pregnancy: What you need to know

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A pituitary tumor is the occurrence of a tumor located in the pituitary gland. This tumor causes the pituitary gland to make too much or too little hormone that affects the functions of the body. Many pregnancies with pituitary tumors cause many difficulties for the patient and the fetus.

1. What is high prolactin during pregnancy?

High prolactin during pregnancy is caused by an abnormal growth of a tumor in the pituitary gland. High prolactin during pregnancy is seen in pituitary adenoma. A part of the brain responsible for regulating the balance of hormones (hormones) of the body. But the very appearance of a pituitary tumor can lead to the overproduction of hormones that control the body's functions. Or conversely, some pituitary tumors appear, causing the production of hormones to be less, resulting in the body not having enough of the necessary hormones.
Most pituitary tumors are benign (non-cancerous, also called adenomas). The pituitary tumor will still exist or grow in the pituitary gland or surrounding tissues but will not spread to other parts of the body.
Pituitary tumors cause infertility by secreting the hormone prolactin leading to a decrease in sex hormones (estrogen in women and testosterone in men). Too much prolactin in the blood affects men and women in different ways. In women, prolactin-secreting pituitary tumors can disrupt the body's hormonal balance, inhibit ovulation, and cause infertility. female.
High prolactin can prevent ovulation in women. When this happens, a woman's menstrual cycle will stop completely (amenorrhea) and she will lose the ability to have children. To a lesser extent, people with high prolactin levels still have normal periods, still ovulate, but do not produce enough progesterone hormone after ovulation, making the fertilized egg unable to implant, leading to infertility in women. female.

2. When can a patient with a pituitary tumor get pregnant safely?

You can still get pregnant with a safe pituitary tumor. However, pregnancy is only safe if:
Your pituitary tumor is less than 10mm Your pituitary gland is larger than 10mm but you have been treated with medication and the tumor has shrunk, or your tumor has been removed. surgery

According to studies, it has been shown that most of the small tumors under 10mm do not develop during pregnancy, or grow insignificantly. So it's safe for you to still get pregnant with a pituitary tumor. If the prolactin-secreting pituitary tumor is smaller than 10mm, you will rarely need drug treatment during pregnancy. For pituitary adenomas larger than 10mm, 30% of patients had larger tumors that grew larger during pregnancy and required intervention. This increases the risk of miscarriage, stillbirth, and birth defects with treatment. When having problems like the above, you should consult an obstetrician, endocrinologist, and neurologist before deciding to get pregnant.
If you are pregnant with a pituitary tumor that will be treated with medicine (bromocriptine or cabergoline or quinagolide) and find out you are pregnant, you must immediately stop taking the medicine and see your doctor for advice.

3. How should you monitor if you are pregnant with a pituitary tumor?

For the case of pregnancy with a pituitary tumor but the tumor is less than 10mm, you are completely healthy, you can go home and rest assured, without using any medicine.
The two most important symptoms to watch for are eyesight and headaches. Cases of pituitary gland tumor that require immediate medical attention such as:
If you have blurred vision, double vision or abnormal vision, you must see a doctor immediately, and inform the doctor about your symptoms, history pituitary tumor. If you have a new headache, or if your headache is increasing, or if your headache is severe, you should see a doctor right away, without delay. If you have any unusual symptoms, you should go to the hospital for examination and advice. If you still feel very well, it is still best to visit an ophthalmologist for a vision test, measuring the visual field once a month because sometimes it is not easy to know that you have a vision loss. The address where you need to go or the doctor you need to consult is a hospital with an endocrinologist, an obstetrician, and a neurosurgeon.

4. At the hospital, how will the doctors evaluate your illness?

Usually, your doctor will re-evaluate your vision, visual field. You will also be measured pituitary hormone in the blood to determine the level of prolactin in the blood , to determine the degree of hypopituitarism . In case of need, your doctor will give you magnetic resonance imaging to determine the size of the tumor.

5. When do you need treatment?

If the doctor confirms that your vision is gradually decreasing, you have hypopituitarism, prolactin levels increase much, the pituitary tumor size is too large, the doctor will conduct treatment. Treatment depends on the condition of your pituitary tumor.

Treatments for getting pregnant with a pituitary tumor
Taking medication People who are pregnant with a pituitary tumor have a very small tumor and no symptoms that usually don't need treatment or a doctor prescribes medication when needed. Currently, the only drug used during pregnancy is bromocriptine because it is safe and does not affect the fetus. Most patients will be stable, tumors are smaller, headaches are reduced, vision improves with this treatment regimen. A very small number of cases require surgery when drugs do not work (drug resistance) or complications are more severe.
Surgery In case of pregnancy when the pituitary gland tumor is too large, leading to pressure on the optic nerve, the doctor will perform surgery. In most cases, pituitary tumors can be surgically removed and removed through the nose and sinuses. If tumors cannot be removed this way, the doctor will remove them through the skull.
Radiation Therapy Radiation therapy can also be used to shrink tumors for people who cannot have surgery. This method is also used in cases of pituitary tumors that recur after surgery.
However, patients need to have regular follow-up visits for blood tests and MRI scans to make sure tumors are not growing.
Vinmec International General Hospital offers a Package Maternity Care Program for pregnant women right from the first months of pregnancy with a full range of antenatal care visits, periodical 3D and 4D ultrasounds and routine tests to ensure that the mother is healthy and the fetus is developing comprehensively.
Pregnant women will be consulted and checked for health under the close supervision of experienced and specialized Obstetricians, helping mothers have more knowledge to protect their health during pregnancy as well as reduce reduce complications for mother and child.

Please dial HOTLINE for more information or register for an appointment HERE. Download MyVinmec app to make appointments faster and to manage your bookings easily.