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Pregnancy complicated by multiple pituitary hormone deficiencies.

Abstract
We report a case of pituitary dwarfism and diabetes insipidus due to pituitary stalk transection in a pregnant Japanese woman, 138 cm in height, born by breech delivery with no evidence of ante- or intrapartum asphyxia. The patient had no central nervous disturbance, was diagnosed with pituitary dwarfism during childhood and was treated at another hospital with growth hormone supplement from 5 to 14 years of age. This patient was referred to our department at 17 weeks' gestation due to a change of residence. At 30 weeks' gestation, she was hospitalized for assessment of hydronephrosis and polyuria (15-20 L/day). Analysis of a 24-h urine sample showed creatinine clearance of 157 mL/min and urine osmolality of 38 mOsm/L. The patient's urine output decreased after receiving a test dose of 0.75 g of 1-desamino-8-D-arginine vasopressin (DDAVP). Cranial magnetic resonance imaging showed transection of the pituitary stalk. Subsequently, the patient's urine output was well controlled by a maintenance dose of 0.275 mL/day intranasal DDAVP. A cesarean section was performed at 37 weeks, as the patient height was 138 cm, and a pelvic X-ray showed cephalopelvic disproportion. She delivered a female baby weighing 2302 g, and both 1- and 5-min Apgar scores were 9. The patient was followed up after 4 months and showed no visual deterioration or polyuria while on DDAVP therapy, while the neonate grew favorably.
AuthorsTatsuya Fukami, Yasuo Makino, Tatsuhiko Kawarabayashi
JournalThe journal of obstetrics and gynaecology research (J Obstet Gynaecol Res) Vol. 32 Issue 2 Pg. 252-6 (Apr 2006) ISSN: 1341-8076 [Print] Australia
PMID16594933 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Pituitary Hormones
  • Human Growth Hormone
  • Deamino Arginine Vasopressin
Topics
  • Adult
  • Breech Presentation
  • Deamino Arginine Vasopressin (administration & dosage)
  • Diabetes Insipidus (complications)
  • Dwarfism, Pituitary (complications)
  • Female
  • Human Growth Hormone (deficiency)
  • Humans
  • Hydronephrosis (complications)
  • Magnetic Resonance Imaging
  • Pituitary Gland (injuries)
  • Pituitary Hormones (deficiency)
  • Polyuria (complications)
  • Pregnancy
  • Pregnancy Complications
  • Pregnancy Outcome

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