Pregnancy in acromegaly

With advances in surgical and medical treatment and the availability of assisted reproductive techniques, pregnancy in women with acromegaly is more frequently encountered. Diagnosis of acromegaly during pregnancy is difficult because of changes in growth hormone and insulin like growth factor-1 (IG...

Full description

Bibliographic Details
Main Author: Bashir A. Laway
Format: Article
Language:English
Published: SAGE Publishing 2015-12-01
Series:Therapeutic Advances in Endocrinology and Metabolism
Online Access:https://doi.org/10.1177/2042018815603927
_version_ 1818323171518971904
author Bashir A. Laway
author_facet Bashir A. Laway
author_sort Bashir A. Laway
collection DOAJ
description With advances in surgical and medical treatment and the availability of assisted reproductive techniques, pregnancy in women with acromegaly is more frequently encountered. Diagnosis of acromegaly during pregnancy is difficult because of changes in growth hormone and insulin like growth factor-1 (IGF-1) axis secondary to placental production of growth hormone. The difficulty is compounded by the inability of routine hormone assays to detect placental growth hormone. In the majority of patients with acromegaly, pregnancy does not have an adverse effect on mother or fetus and pituitary mass does not increase in size. The level of IGF-1 usually remains stable because of the effect of estrogen causing a growth hormone resistant state. In patients with pituitary macroadenoma, the possibility of an increase in size of the pituitary mass needs to be kept in mind and more frequent monitoring is required. In case of tumor enlargement, pituitary surgery can be considered in the mid trimester. Experience with the use of medical treatment for acromegaly during pregnancy is increasing. Dopamine agonists, somatostatin analogs or growth hormone receptor antagonists have been used without any adverse consequences on mother or fetus. At present, it is advisable to stop any medical treatment after confirmation of pregnancy till more data are available on the safety of these drugs.
first_indexed 2024-12-13T11:08:27Z
format Article
id doaj.art-eed704b6e2024f0194b1704b55d88e1c
institution Directory Open Access Journal
issn 2042-0188
2042-0196
language English
last_indexed 2024-12-13T11:08:27Z
publishDate 2015-12-01
publisher SAGE Publishing
record_format Article
series Therapeutic Advances in Endocrinology and Metabolism
spelling doaj.art-eed704b6e2024f0194b1704b55d88e1c2022-12-21T23:48:53ZengSAGE PublishingTherapeutic Advances in Endocrinology and Metabolism2042-01882042-01962015-12-01610.1177/2042018815603927Pregnancy in acromegalyBashir A. LawayWith advances in surgical and medical treatment and the availability of assisted reproductive techniques, pregnancy in women with acromegaly is more frequently encountered. Diagnosis of acromegaly during pregnancy is difficult because of changes in growth hormone and insulin like growth factor-1 (IGF-1) axis secondary to placental production of growth hormone. The difficulty is compounded by the inability of routine hormone assays to detect placental growth hormone. In the majority of patients with acromegaly, pregnancy does not have an adverse effect on mother or fetus and pituitary mass does not increase in size. The level of IGF-1 usually remains stable because of the effect of estrogen causing a growth hormone resistant state. In patients with pituitary macroadenoma, the possibility of an increase in size of the pituitary mass needs to be kept in mind and more frequent monitoring is required. In case of tumor enlargement, pituitary surgery can be considered in the mid trimester. Experience with the use of medical treatment for acromegaly during pregnancy is increasing. Dopamine agonists, somatostatin analogs or growth hormone receptor antagonists have been used without any adverse consequences on mother or fetus. At present, it is advisable to stop any medical treatment after confirmation of pregnancy till more data are available on the safety of these drugs.https://doi.org/10.1177/2042018815603927
spellingShingle Bashir A. Laway
Pregnancy in acromegaly
Therapeutic Advances in Endocrinology and Metabolism
title Pregnancy in acromegaly
title_full Pregnancy in acromegaly
title_fullStr Pregnancy in acromegaly
title_full_unstemmed Pregnancy in acromegaly
title_short Pregnancy in acromegaly
title_sort pregnancy in acromegaly
url https://doi.org/10.1177/2042018815603927
work_keys_str_mv AT bashiralaway pregnancyinacromegaly