Pituitary Disorders in Pregnancy.

The management of pituitary disorders in pregnancy presents a unique challenge for maternal medicine specialists and endocrinologists. Advances in assisted reproductive technologies (ART) mean that women with hypopituitarism are increasingly able to conceive. The pituitary undergoes significant physiological changes during pregnancy. Pituitary hormone replacement regimens must therefore be adjusted throughout pregnancy in an attempt to mimic these pregnancy-related changes. Close clinical and biochemical follow up and collaboration across specialities is essential to ensure optimal maternal and foetal outcomes. Although many women with hypopituitarism will have a normal pregnancy, rates of miscarriage, labour induction and caesarean sections are higher than the general population. Most women with hypopituitarism are diagnosed prior to pregnancy, however, some pituitary disorders including lymphocytic hypophysitis, Sheehan's Syndrome and pituitary apoplexy have a predilection to arise during pregnancy or the post-partum period. Prompt recognition of these disorders is essential to prevent potentially fatal complications and optimise maternal and foetal wellbeing.