Other Disorders of the Pituitary and Hypothalamus in Pregnancy

Pregnancy results in significant alteration of pituitary anatomy and hormone physiology. Prolactin-producing lactotroph cells undergo progressive and significant hyperplasia throughout pregnancy contributing to increase in size of the anterior pituitary. Changes in pituitary hormone production, binding protein levels and target hormone action occur during pregnancy. As a result of these alterations, the assessment of pituitary status in the pregnant woman is complex and differs from the non-pregnant state. Disorders of hormone function may be well established prior to pregnancy or less frequently develop during pregnancy. These conditions may impact on maternal and fetal outcomes and influence pregnancy management. The physiology of pregnancy may also influence behaviour of endocrine conditions. Several disorders are specifically associated with pregnancy, lymphocytic hypophysitis, and Sheehan’s syndrome being particular examples.