title: Pituitary apoplexy in pregnancy: A case series and literature review.
abstract: BACKGROUND
  Severe headache during pregnancy is a challenging condition that may rarely imply endocrine disturbances. Rapid recognition of pituitary apoplexy is needed to improve pregnancy outcome.
  
  
  OBJECTIVE
  To review and compare maternal and fetal outcomes after pituitary apoplexy.
  
  
  METHODS
  Four cases of pituitary apoplexy during pregnancy in our centre are reported and literature review covering the past 54 years was performed.
  
  
  RESULTS
  In the four cases presented and the 33 reported in the literature, most women presented with severe headaches and systemic symptoms. Overall, 42% were treated surgically, 31% received bromocriptine or cabergoline and 61% were given hormone replacement. No major obstetrical complication was reported and all babies were healthy.
  
  
  CONCLUSIONS
  Pituitary apoplexy is a rare cause of sudden and severe headache during pregnancy. Rapid identification of this condition with potentially associated endocrine disturbances is important to ensure maternal and fetal well-being. A multidisciplinary team approach seems to reduce morbidity and mortality.
authors: Internal Medicine Division, Department of Medicine, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada.
authors: Sophie
authors: S
authors: Grand'Maison
authors: Internal Medicine Division, Department of Medicine, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada.
authors: Florence
authors: F
authors: Weber
authors: Obstetrics Division, Department of Gynecology and Obstetrics, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada.
authors: Marie-Josée
authors: MJ
authors: Bédard
authors: Internal Medicine Division, Department of Medicine, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada.
authors: Michele
authors: M
authors: Mahone
authors: Endocrinology Division, Department of Medicine, Centre de Recherche du Centre hospitalier de l'Université de Montréal (CR-CHUM), Montreal, QC, Canada.
authors: Ariane
authors: A
authors: Godbout
keywords: Pituitary; apoplexy; endocrine insufficiency; pregnancy