Korean J Obstet Gynecol.  2002 Nov;45(11):2015-2019.

Panhypopituitarism in a Pregnant Woman with Ovarian Hyperstimulation Syndrome and Residual Pituitary Adenoma

• Chung SI
• Kwon YS
• Cho JH
• Moon JY
• Lee BH
• Oh YM
• Kim SH
• Chae HD
• Kim CH
• Kang BM

Abstract

Ovarian hyperstimulation syndrome (OHSS) is one of the most serious complication of controlled ovarian hyperstimulation (COH) and ovulation induction. High serum estradiol concentration can induce the increase of capillary permeability and fluid shift, and it can results in hypovolemia, hemoconcetration, thromboembolism, oliguria, ascites and even death. This physiologic changes of OHSS and/or pregnancy might induce the deterioration of pituitary function in patients with abnormal pituitary conditions such as low pituitary reserve or tumor. However, all this while, panhypopituitarism or pituitary apoplexy in a pregnant woman with OHSS and/or pituitary adenoma has not been reported. We have experienced a case of panhypopituitarism developed in a pregnant woman with severe OHSS and residual pituitary adenoma. She had residual prolactinoma, despite a transsphenoidal adenoidectomy, and had suffered from uncontrolled hyperprolactinemia (HPRL) and chronic anovulation. Therefore, she had taken ovulation induction for getting a pregnancy and conceived, but, in the conception cycle, she was hospitalized for management of severe OHSS and hyperemesis gravidarum. During the period of hospitalization, abrupt panhypopituitarism was developed unexpectedly. Therefore, we present this case with the brief review of literature.

Keyword

Ovarian hyperstimulation syndrome (OHSS); Prolactinoma; Pregnancy; Panhypopituitarism

MeSH Terms

Adenoidectomy
Anovulation
Ascites
Capillary Permeability
Estradiol
Female
Fertilization
Hospitalization
Humans
Hyperemesis Gravidarum
Hyperprolactinemia
Hypovolemia
Oliguria
Ovarian Hyperstimulation Syndrome*
Ovulation Induction
Pituitary Apoplexy
Pituitary Neoplasms*
Pregnancy
Pregnant Women*
Prolactinoma
Thromboembolism
Estradiol