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• W4312566470 endingPage "445" @default.
• W4312566470 startingPage "429" @default.
• W4312566470 abstract "During pregnancy, pituitary morphology and function are modified by placental hormonal secretion. Pituitary volume is increased due to lactotroph hypertrophy and hyperplasia. Placental sex steroids inhibit GnRH and gonadotropin secretion. The placenta secretes a variant isoform of GH, increasing IGF-1 levels. TSH secretion decreases in the first trimester, secondary to thyroid stimulation by human chorionic gonadotropin. Hepatic production of thyroid-binding globulin is stimulated by estrogens, increasing total T4 and T3. Placental CRH stimulates pituitary and placental ACTH, increasing cortisol levels throughout pregnancy. Infertility is common in patients harboring pituitary tumors. Pathophysiology includes hormonal hypersecretion and tumoral mass effect. Hypopituitarism can also result from surgery and/or radiotherapy for pituitary adenoma treatment. Hyperprolactinemia, occurring in prolactinomas, the most common subtype of pituitary adenomas, and other pituitary tumors, inhibits GnRH pulsatility. Different mechanisms seem to play a role in hypogonadism of patients harboring acromegaly: tumoral gonadotroph compression, hyperprolactinemia, and GH/IGF-1 excess disrupting gonadal axis. In Cushing's disease, hypogonadism is mainly due to the negative impact of hypercortisolism and hyperandrogenism in the gonadotrophic axis. Clinically nonfunctioning pituitary tumors seldom are associated with pregnancy. In pituitary adenomas, treatment is often necessary to control hormonal hypersecretion and tumor mass effect related to infertility. Other causes of infertility include lymphocytic hypophysitis and Sheehan's syndrome. This chapter reviews the pathophysiology, diagnosis, and therapeutic approaches for women with pituitary diseases, before and during pregnancy, in order to induce fertility and avoid the deleterious effects of hormonal hyper- or hyposecretion." @default.
• W4312566470 created "2023-01-05" @default.
• W4312566470 creator A5089321205 @default.
• W4312566470 creator A5089936302 @default.
• W4312566470 date "2022-01-01" @default.
• W4312566470 modified "2023-09-23" @default.
• W4312566470 title "The Pituitary Gland in Pregnancy" @default.
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