Jewelewicz R, Zimmerman E A, Carmel P W
Fertil Steril. 1977 Jan;28(1):35-40. doi: 10.1016/s0015-0282(16)42314-9.
Ovulation induced with human menopausal gonadotropin-human chorionic gonadotropin in a 27-year-old woman who had been amenorrheic for 7 years resulted in pregnancy. Although pretreatment neurologic evaluation was normal, significant loss of vision was found at 30 weeks' gestation, and a skull x-ray revealed enlargement and erosion of the sella turcica. As an attempt to delay surgery, 12 mg of dexamethasone daily arrested further visual deterioration, and the pregnancy continued uneventful for 36 weeks, when triplets were born. Five days after delivery the visual fields were normal. Trans-sphenoidal resection of a prolactin-secreting chromophobe adenoma of the pituitary was carried out 6 months later. It is suggested that when disturbance in visual perception due to a pituitary tumor occurs during pregnancy, a course of high-dose corticosteroids with frequent monitoring of visual fields and acuity might be tried before surgical intervention. Although further rapid deterioration in vision may dictate immediate surgical decompression, conservative management may result in stabilization, allowing the patient to carry the pregnancy to term and obviating the need for emergency surgery.
一名闭经7年的27岁女性使用人绝经期促性腺激素 - 人绒毛膜促性腺激素诱导排卵后怀孕。尽管术前神经学评估正常，但在妊娠30周时发现视力显著下降，颅骨X线检查显示蝶鞍增大并被侵蚀。为了尝试推迟手术，每日给予12毫克地塞米松阻止了视力的进一步恶化，妊娠顺利持续至36周，产下三胞胎。分娩后五天视野恢复正常。6个月后进行了经蝶窦切除垂体分泌催乳素的嫌色细胞瘤手术。建议当妊娠期因垂体肿瘤出现视觉感知障碍时，在手术干预前可尝试使用大剂量皮质类固醇疗程，并频繁监测视野和视力。尽管视力进一步快速恶化可能需要立即进行手术减压，但保守治疗可能会使病情稳定，使患者能够足月分娩，避免紧急手术的需要。
