Afecciones hipofisarias durante la gestación: un seguimiento de cinco años. Pituitary conditions during pregnancy: A five-year follow up

Las endocrinopatias durante la gestacion son entidades con caracteristicas propias. La disfuncion hipofisaria es infrecuente pero no menos importante. Estudiamos 30 mujeres embarazadas con afecciones hipofisarias que asistian a consulta provincial de Endocrinologia y Gestacion creada al efecto. El promedio de edad fue de 19,3 ± 6,1 anos, predominando la raza blanca. Se determino por trimestres TSH, LH, FSH y Prl, asi como FO y campimetria. Como resultado obtuvimos que predomino el microadenoma de hipofisis en 16 casos; seguido de la silla turca vacia primaria o secundaria, con 6 casos; el craneofaringeoma, macroadenoma operado y diabetes insipida fueron los menos frecuentes. Hormonalmente se aprecio un marcado aumento de la prolactina en todos los trimestres de la gestacion, no asi de la FSH y LH, que se mantuvieron normales, pero bajos. La TSH no sufrio variacion alguna. En cuanto al tratamiento solo 3 pacientes con microadenoma necesitaron la toma de Parlodel durante la gestacion. Concluimos que no encontramos crecimiento tumoral en las portadoras de microadenoma; tampoco se reporto malformacion alguna en las que tomaron Bromocriptina durante la gestacion. Algunas pacientes presentaron hipogalactia despues del cese del embarazo. DeCS: GLANDULA PITUITARIA, DIABETES INSIPIDA, EMBARAZO, SILLA TURCA. ABSTRACT Endocrinopathics during pregnancy are entities with proper characteristics. Hypophyseal dysfunction is not frequent but not less important. Thirty pregnant suffering from hypophyseal disorders were studied, all them attended to Provincial Endocrinology and Pregnancy Consultations. The average age was 19.3 ± 6.1 years, prevailing the Caucasian race. TSH, 1H, FSH and Prl as well as FO and campimetry were determined quarterly. Results obtained showed that microadenoma of the hypophysis prevailed in 16 cases followed by empty primary or secondary sella (turcica) syndrome (6 cases), being less frequent craniopharingeoma, macroadenoma (operated on) and diabetes insipidus, in hormones there was a marked increase of prolactine in all quarterlies of pregnancy, FSH and 1H had normal standards but low, THS showed no variations. Only 3 patients suffering from microadenoma needed the administration of Parlodel during pregnancy. Concluding that no tumour growth was found in patients suffering from microadenoma, malformation was not reported in women taking Bromocriptine during pregnancy. Some women presented hypogalactia after pregnancy. DeCS: PITITUARY GLAND, DIABETES INSIPIDUS, PREGNANCY, SELLA TURCICA.