Maternal and fetal effects of acromegaly on pregnancy. Clinical Practice and Drug Treatment

Abstract

INTRODUCTION: Pregnancy in acromegaly is usually rare. Acromegaly is related with secondary hypogonadism, hyperandrogenemia, hyper prolactin and pregnancy is difficult in acromegaly, however, some women with acromegaly may be become pregnant, which brings along questions about maternal and fetal effects and medical therapy and treatment. This review helps to address these points and helps clinical information. METHODS: This review summarizes maternal and fetal effects of acromegaly on pregnancy and medical treatment RESULTS AND CONCLUSION: Acromegaly can effect on pregnancy. In summary, fertility is usually compromised in acromegaly due to hyperandrogenemia, impairment of gonadotropin-secreting cells and decreased secretion of luteinizing hormone (LH) and follicle stimulating hormone (FSH) as a result of tumoral mass effect (pituitary stalk compression) or treatment (surgery and radiotherapy) or hypopituitarism, high prolactin hormone levels due to pituitary stalk compression and a mixed GH-prolactin secreting adenoma and direct effect of excess GH/IGF-I on the gonadotropic axis.1-6 Pregnancy may become complicated with gravid hypertension, preeclampsia and gestational diabetes mellitus. 7 Dopaminergic drugs, octreotide, pegvisomant and surgery are different modalities for treatment acromegaly in pregnancy. 8-13