Peel Andrew, Teasdale Stephanie, Morton Adam
Mater Hospital Brisbane, South Brisbane, Queensland, Australia.
Obstet Med. 2025 May 21:1753495X251338154. doi: 10.1177/1753495X251338154.
Physiological pituitary hyperplasia is due to adenohypophyseal cell number increase and is characterised by diffuse isodense pituitary enlargement beyond age-appropriate sizes. It most commonly occurs in females undergoing reproductive changes (puberty, pregnancy, menopause). We report a case of pituitary hyperplasia (pituitary height 14 mm) in a 33-year-old female presenting as vision changes at 34 weeks 'gestation. Computer visual fields identified right sided superotemporal visual field loss with current retinal nerve fibre layer assessment suggestive of compressive optic neuropathy. Serial visual assessment was performed, and due to progression, a caesarean section was performed at 38 weeks' gestation. Cabergoline was not utilised, and one month following delivery, visual findings had resolved, and pituitary height had reduced to 11 mm. There is limited data regarding management for pituitary hyperplasia causing compressive neuropathy irrespective of pregnancy. This case highlights the temporary nature of hypertrophy during pregnancy and positive visual outcome with conservative interventions.
生理性垂体增生是由于腺垂体细胞数量增加所致，其特征是垂体弥漫性等密度增大，超出了与年龄相符的大小。它最常见于经历生殖变化（青春期、怀孕、更年期）的女性。我们报告一例33岁女性垂体增生（垂体高度14 mm）病例，该患者在妊娠34周时出现视力变化。计算机视野检查发现右侧颞上象限视野缺损，当前视网膜神经纤维层评估提示存在压迫性视神经病变。进行了系列视力评估，由于病情进展，在妊娠38周时进行了剖宫产。未使用卡麦角林，产后1个月，视力检查结果恢复正常，垂体高度降至11 mm。关于无论是否怀孕，由垂体增生引起压迫性神经病变的管理数据有限。该病例突出了孕期肥大的暂时性以及保守干预对视力的良好预后。
