Overcoming anaesthetic challenges in a pregnant woman with pituitary apoplexy undergoing endoscopic trans-sphenoidal resection of the pituitary tumour.
Priya ThappaCharu SharmaAshwini ReddyAmiya Kumar BarikPublished in: BMJ case reports (2023)
Pituitary apoplexy is a rare condition that occurs due to acute haemorrhage in the pituitary gland and usually presents with features of acute hypopituitarism, visual defects and ophthalmoplegia. Pregnancy is one of the risk factors for pituitary apoplexy. Medical management is the first line of management in pregnancy irrespective of the gestational age. However, acute neuro-ophthalmological deterioration might warrant an urgent surgical decompression. Preoperative corticosteroids have dual benefits of providing hormonal replacement in the mother and also promoting fetal lung maturity in the offspring. Uterine contractions should be monitored and tocolysis provided as per requirements in a post-viable fetus.
Keyphrases
- pregnancy outcomes
- pregnant women
- liver failure
- growth hormone
- respiratory failure
- gestational age
- drug induced
- aortic dissection
- preterm birth
- patients undergoing
- metabolic syndrome
- birth weight
- hepatitis b virus
- insulin resistance
- minimally invasive
- type diabetes
- adipose tissue
- mechanical ventilation
- acute respiratory distress syndrome
- skeletal muscle
- case report
- weight loss