title: Pregnancy and acromegaly: a review.
abstract: To review the literature regarding the diagnosis and management of acromegaly during pregnancy. A systematic literature search was performed using MEDLINE including hand-searching reference lists from original articles. The diagnosis of acromegaly during pregnancy is made difficult due to the physiologic changes in pituitary GH secretion and IGF-1 production resulting from placental GH secretion and the inability of commercial assays to discriminate between pituitary and placental GH. Most patients with acromegaly during pregnancy do not have an increase in tumor size, metabolic complications are uncommon, and neonatal outcome is largely unaffected. IGF-1 levels tend to be stable in such patients possibly due to the high estrogen levels causing GH resistance. Dopamine agonists, somatostatin analogues, and a GH receptor antagonist have been reported to be safe during pregnancy. Patients with visual field defects should be considered for surgery, but in most cases this can be safely postponed until after delivery. Overall, pregnancy in acromegaly is uneventful and newborns unaffected. Dopamine agonists and somatostatin analogues have not been associated with major adverse effects to the fetus; however, more data are needed to validate their safety.
authors.affiliation: Endocrinology and Metabolism Institute, Cleveland Clinic, 9500 Euclid Ave, Desk F20, Cleveland, OH 44195, USA.
authors.forename: Vicky
authors.initials: V
authors.lastname: Cheng
authors.forename: Charles
authors.initials: C
authors.lastname: Faiman
authors.forename: Laurence
authors.initials: L
authors.lastname: Kennedy
authors.forename: Fadi
authors.initials: F
authors.lastname: Khoury
authors.forename: Betul
authors.initials: B
authors.lastname: Hatipoglu
authors.forename: Robert
authors.initials: R
authors.lastname: Weil
authors.forename: Amir
authors.initials: A
authors.lastname: Hamrahian
mesh_terms: D000172:Acromegaly / Q000150:complications* / Q000378:metabolism; D005260:Female; D019382:Human Growth Hormone / Q000378:metabolism; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D011247:Pregnancy; D011248:Pregnancy Complications
chemical_list: D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I