Surgical management of pituitary adenoma during pregnancy

Table 1 Basic information and clinical symptoms of pregnant patients who underwent surgery for pituitary adenoma

Data source	Case	Age, yr	Sex	Clinical symptoms
				Headache	Vision loss	Visual field	OP	DI	HT	CS	Acromegaly
Peking Union Medical College Hospital	1	29	F	No	Bi	BTH	No	No	No	No	No
	2	36	F	Yes	Bi	BTH	No	No	No	No	No
	3	34	F	No	Bi	BTH	Yes	Yes	No	No	No
	4	32	F	No	No	No	No	No	Yes	No	No
	5	37	F	Yes	Mo	BTH	No	No	No	No	No
	6	28	F	Yes	Bi	BTH	No	No	No	No	No
Jallad et al[16]	7	25	F	Yes	No	BTH	No	No	No	No	Yes
	8	27	F	Yes	No	BTH	No	No	No	No	Yes
	9	27	F	Yes	No	BTH	No	No	No	No	Yes
Chaiamnuay et al[17]	10	39	F	Yes	No	UTH	No	No	Yes	No	No
Guven et al[18]	11	32	F	No	Bi	BTH	No	No	No	No	Yes
Zhong et al[38]	12	29	F	No	Bi	No	No	No	No	No	No
Jemel et al[19]	13	35	F	Yes	No	BTH	No	No	No	No	No
	14	30	F	Yes	Bi	BTH	No	No	No	No	No
Xia et al[20]	15	25	F	Yes	Bi	BTH	No	No	No	No	No
Yamaguchi et al[21]	16	35	F	Yes	Bi	UTH	No	No	No	No	No
Tandon et al[22]	17	27	F	Yes	Mo	BTH	No	No	No	No	No
Parihar et al[36]	18	22	F	Yes	Bi	No	No	No	No	No	No
Gondim et al[23]	19	29	F	Yes	Mo	UTH	Yes	No	No	No	No
Witek et al[24]	20	25	F	Yes	Bi	BTH	No	No	No	No	No
Kita et al[25]	21	26	F	Yes	No	BTH	No	No	No	No	No
Nossek et al[26]	22	29	F	No	Bi	No	No	No	No	No	No
	23	34	F	No	No	BTH	No	No	No	No	No
Iuliano and Laws[27]	24	28	F	Yes	No	No	No	No	No	No	No
	25	35	F	Yes	Mo	UTH	Yes	No	No	No	No
Hayes et al[28]	26	41	F	Yes	No	BTH	No	No	No	No	No
Boronat et al[52]	27	26	F	No	No	No	No	No	No	Yes	No
Abbassy et al[37]	28	38	F	Yes	No	No	No	No	No	Yes	No
Coyne et al[53]	29	22	F	No	No	No	No	No	No	Yes	No
Pinette et al[54]	30	33	F	No	No	No	No	No	No	Yes	No
Ross et al[55]	31	24	F	No	No	No	No	No	No	Yes	No
Mellor et al[51]	32	40	F	No	No	No	No	No	No	Yes	No
Karaca et al[15]	33	NA	F	No	No	No	Yes	No	No	No	Yes
Jolly et al[56]	34	30	F	No	No	No	No	No	No	Yes	No
Galvão et al[29]	35	NA	F	Yes	Bi	BTH	No	No	No	No	No
Abid et al[30]	36	25	F	Yes	Bi	BTH	No	No	No	No	No
Barraud et al[31]	37	NA	F	Yes	No	BTH	No	No	No	No	No
Freeman et al[32]	38	22	F	Yes	Mo	BTH	No	Yes	No	No	No
Lunardi et al[33]	39	21	F	Yes	Bi	BTH	No	No	No	No	Yes
Oguz et al[34]	40	26	F	Yes	No	UTH	No	No	No	No	No
O’Neal[35]	41	27	F	Yes	No	BTH	No	No	No	No	No

Bi: Binocular; BTH: Bitemporal hemianopsia; CS: Cushing syndrome; DI: Diabetes insipidus; F: Female; HT: Hyperthyroidism; Mo: Monocular; OP: Oculomotor paralysis; NA: Not available; UTH: Unilateral temporal hemianopia.

Table 2 Treatment and follow-up outcomes of pregnant patients who underwent surgery for pituitary adenoma

Ref.	Case	Treatment				Pathology	Follow up
		Medical therapy		Operation	Delivery		M	I
		Pre	Post
Peking Union Medical College Hospital	1	Bromocriptine	No	12th W TSS	40th W CS	NF PA	ER	H
	2	No	No	32nd W TSS	Full term CS	NF PA	ER	H
	3	No	No	22nd W TSS	38th W CS	NF PA	ER	H
	4	Sandostatin	No	26th W TSS	38th W CS	TSH PA	ER	H
	5	Bromocriptine	No	35th W TSS	35th W CS	PRL PA	ER	H
	6	Prednisone, thyroxine	Prednisone, thyroxine	30th W TSS	39th W CS	NF PA	ER	H
Jallad et al[16]	7	No	No	3rd Mon TSS	38thW CS	GH PA	ER	H
	8	No	No	4th Mon TSS	16th W A	GH PA	EC	A
	9	Cabergoline	No	4th Mon TSS	39th W CS	GH PA	ER	H
Chaiamnuay et al[17]	10	Propylthiouracil, bromocriptine	No	27th W TSS	39th W CS	TSH PA	ER	H
Guven et al[18]	11	No	Octreotide	34th W TSS	34th W CS	GH PA	EC	H
Zhong et al[38]	12	No	Cortisone, thyroxine	22nd W TSS	40th W VD	NF PA	ER	H
Jemel et al[19]	13	Cabergoline, hydrocortisone	No	22nd W TSS	37th W VD	NF PA	ER	H
	14	Corticosteroids	No	24th W TSS	38th W VD	NF PA	ER	H
Xia et al[20]	15	No	No	24th W TSS	38th W CS	PRL PA	ER	H
Yamaguchi et al[21]	16	No	Methyl prednisolone	36th W TSS	37th W CS	PRL PA, Optic neuritis	ER	H
Tandon et al[22]	17	Bromocriptine	Desmopressin	36th W TSS	37th W CS	PRL PA	ER	H
Parihar et al[36]	18	No	No	20th W TSS	Full term VD	PRL PA	ER	H
Gondim et al[23]	19	Bromocriptine	Thyroxine, hydrocortisone	32nd W TSS	39th W VD	PRL PA	EC	H
Witek et al[24]	20	Bromocriptine	Hydrocortisone	20th W TSS	38th W CS	PRL PA	ER	H
Kita et al[25]	21	No	DDAVP	27th W TSS	40th W VD	NF PA	ER	H
Nossek et al[26]	22	No	No	33rd W TSS	35th W CS	PA	ER	LAS
	23	No	No	31st W TSS	40th W VD	PA	ER	H
Iuliano and Laws[27]	24	Bromocriptine, dexamethasone	No	30th W TSS	39th W CS	NF PA	ER	H
	25	Bromocriptine, dexamethasone	Levothyroxine, hydrocortisone	33rd W TSS	39th W CS	NF PA	ER	H
Hayes et al[28]	26	Corticosteroids	No	18th W TSS	Full term VD	PRL PA	ER	H
Boronat et al[52]	27	Alpha-metildopa	Metyrapone	16th W TSS	34th W VD	ACTH PA	R	H
Abbassy et al[37]	28	No	Hydrocortisone, desmopressin	18th W TSS	39th W VD	ACTH PA	ER	H
Coyne et al[53]	29	No	Hydrocortisone, desmopressin	14th W TSS	38th W VD	ACTH PA	ER	H
Pinette et al[54]	30	No	Atenolol	16th W TSS	-	ACTH PA	ER	D
Ross et al[55]	31	No	Dexamethasone	18th W TSS	37th W CS	ACTH PA	ER	H
Mellor et al[51]	32	No	Hydrocortisone	Mid-trimester TSS	34th W CS	ACTH PA	ER	H
Karaca et al[15]	33	No	No	11th W TSS	39th W CS	GH PA	ER	H
Jolly et al[56]	34	No	Hydrocortisone, metformin, labetalol, nifedipine	23rd W TSS	38th W CS	ACTH PA	ER	D
Galvão et al[29]	35	No	No	2nd trimester TSS	-	PRL PA	ER	H
Abid et al[30]	36	Bromocriptine	Lisuride hydrogen	27th W TSS	39th W VD	PRL PA	ER	H
Barraud et al[31]	37	Bromocriptine	No	4th Mon TSS	-	PRL PA	ER	H
Freeman et al[32]	38	DDAVP	Hydrocortisone, thyroxine, DDAVP	32nd W TSS	39th W VD	PRL PA	ER	H
Lunardi et al[33]	39	No	No	6th Mon TSS	Full term VD	GH PA	EC	H
Oguz et al[34]	40	No	Levothyroxine	23rd W TSS	37th W CS	PRL PA	ER	H
O’Neal[35]	41	Hydrocortisone, bromocriptine	No	29th W TSS	37th W VD	PA	ER	H

A: Abortion; ACTH: Adrenocorticotropic hormone; CS: Cesarean section; D: Death; DDAVP: 1-Desamino-8-D-arginine vasopressin; EC: Endocrine control; ER: Endocrine remission; GH: Growth hormone; H: Healthy; I: Infant; LAS: Low Apgar score; M: Maternal; NA: Not available; NF: Nonfunctional; PA: Pituitary adenoma; Post: Postoperatively; Pre: Preoperatively; PRL: Prolactin; R: Recurrence; TSH: Thyroid stimulating hormone; TSS: Transsphenoidal surgery; VD: Vaginal delivery.