Anterior and posterior pituitary disease and pregnancy

Hyperprolactinemia commonly causes symptoms of galactorrhea, amenorrhea, and infertility. The differential diagnosis of hyperprolactinemia is extensive. This chapter focuses on the patient with a prolactinoma. Hemorrhage into the tumor causing headache and visual symptoms during pregnancy, however, has been reported several times. Fewer than 150 cases of Cushing's syndrome in pregnancy have been reported. Only three cases have been reported of pregnancy occurring in women with TSH-secreting tumors. Pregnancy would not expected to influence tumor size in patients with clinically nonfunctioning adenomas (CNFAs) and only two cases have been reported in which tumor enlargement during pregnancy resulted in a visual field defect. Acute fatty liver of pregnancy and other disturbances of hepatic function such as hepatitis may be associated with late onset transient diabetes insipidus (DI) of pregnancy in some patients. DI that developing postpartum may be a result of Sheehan's syndrome or lymphocytic hypophysitis.