{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T01:37:29Z","timestamp":1790300249823,"version":"4.1.0"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,5,27]],"date-time":"2021-05-27T00:00:00Z","timestamp":1622073600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,5,27]],"date-time":"2021-05-27T00:00:00Z","timestamp":1622073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Pregnancy is a known risk factor for pituitary apoplexy, which is life threatening for both mother and child. However, very few clinical interventions have been proposed for managing pituitary apoplexy in pregnancy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>We describe the management of three cases of pituitary apoplexy during pregnancy and review available literature. Presenting symptoms in our case series were headache and\/or visual disturbances, and the etiology in all cases was hemorrhage. Conservative therapy was followed until 34\u00a0weeks of gestation, after which babies were delivered by cesarean section with prophylactic bolus hydrocortisone supplementation. Tumor removal was only electively performed after delivery using the transsphenoidal approach. All three patients and their babies had a good clinical course, and postoperative pathological evaluation revealed that all tumors were functional and that they secreted prolactin.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Although the mechanism of pituitary apoplexy occurrence remains unknown, the most important treatment strategy for pituitary apoplexy in pregnancy remains adequate hydrocortisone supplementation and frequent hormonal investigation. Radiological follow-up should be performed only if clinical symptoms deteriorate, and optimal timing for surgical resection should be discussed by a multidisciplinary team that includes obstetricians and neonatologists.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-021-02892-5","type":"journal-article","created":{"date-parts":[[2021,5,26]],"date-time":"2021-05-26T23:08:57Z","timestamp":1622070537000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Treatment and therapeutic strategies for pituitary apoplexy in pregnancy: a case series"],"prefix":"10.1186","volume":"15","author":[{"given":"Yuya","family":"Kato","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6834-6468","authenticated-orcid":false,"given":"Yoshikazu","family":"Ogawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teiji","family":"Tominaga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,5,27]]},"reference":[{"key":"2892_CR1","first-page":"602","volume":"33","author":"DC Bills","year":"1993","unstructured":"Bills DC, Meyer FB, Laws ER, Davis DH, Ebersold MJ, Scheithauer BW, Ilstrup DM, Abboud CF. A retrospective analysis of pituitary apoplexy. Neurosurgery. 1993;33:602\u20138 ((discussion 608\u2013609)).","journal-title":"Neurosurgery"},{"key":"2892_CR2","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1590\/2359-3997000000047","volume":"59","author":"A Glezer","year":"2015","unstructured":"Glezer A, Bronstein MD. Pituitary apoplexy: pathophysiology, diagnosis and management. Arch Endocrinol Metab. 2015;59:259\u201364.","journal-title":"Arch Endocrinol Metab"},{"key":"2892_CR3","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1016\/j.clineuro.2016.07.013","volume":"148","author":"Y Ogawa","year":"2016","unstructured":"Ogawa Y, Niizuma K, Mugikura S, Tominaga T. Ischemic pituitary adenoma apoplexy\u2014clinical appearance and prognosis after surgical intervention. Clin Neurol Neurosurg. 2016;148:142\u20136.","journal-title":"Clin Neurol Neurosurg"},{"key":"2892_CR4","doi-asserted-by":"publisher","first-page":"1444","DOI":"10.3171\/2014.10.JNS141720","volume":"122","author":"EH Oldfield","year":"2015","unstructured":"Oldfield EH, Merrill MJ. Apoplexy of pituitary adenomas: the perfect storm. J Neurosurg. 2015;122:1444\u20139.","journal-title":"J Neurosurg"},{"key":"2892_CR5","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1177\/1753495X15598917","volume":"8","author":"S Grand'Maison","year":"2015","unstructured":"Grand\u2019Maison S, Weber F, Bedard MJ, Mahone M, Godbout A. Pituitary apoplexy in pregnancy: a case series and literature review. Obstet Med. 2015;8:177\u201383.","journal-title":"Obstet Med"},{"key":"2892_CR6","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1007\/s40618-014-0095-4","volume":"37","author":"E Piantanida","year":"2014","unstructured":"Piantanida E, Gallo D, Lombardi V, Tanda ML, Lai A, Ghezzi F, Minotto R, Tabano A, Cerati M, Azzolini C, Balbi S, Baruzzi F, Sessa F, Bartalena L. Pituitary apoplexy during pregnancy: a rare, but dangerous headache. J Endocrinol Invest. 2014;37:789\u201397.","journal-title":"J Endocrinol Invest"},{"key":"2892_CR7","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1111\/j.1365-2265.2010.03913.x","volume":"74","author":"S Rajasekaran","year":"2011","unstructured":"Rajasekaran S, Vanderpump M, Baldeweg S, Drake W, Reddy N, Lanyon M, Markey A, Plant G, Powell M, Sinha S, Wass J. UK guidelines for the management of pituitary apoplexy. Clin Endocrinol (Oxf). 2011;74:9\u201320.","journal-title":"Clin Endocrinol (Oxf)"},{"key":"2892_CR8","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1016\/S0002-9343(88)80346-2","volume":"85","author":"JG Gonzalez","year":"1988","unstructured":"Gonzalez JG, Elizondo G, Saldivar D, Nanez H, Todd LE, Villarreal JZ. Pituitary gland growth during normal pregnancy: an in vivo study using magnetic resonance imaging. Am J Med. 1988;85:217\u201320.","journal-title":"Am J Med"},{"key":"2892_CR9","doi-asserted-by":"publisher","first-page":"93","DOI":"10.4103\/1793-5482.181130","volume":"13","author":"H Ghadirian","year":"2018","unstructured":"Ghadirian H, Shirani M, Ghazi-Mirsaeed S, Mohebi S, Alimohamadi M. Pituitary apoplexy during treatment of prolactinoma with cabergoline. Asian J Neurosurg. 2018;13:93\u20135.","journal-title":"Asian J Neurosurg"}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-021-02892-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13256-021-02892-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-021-02892-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,26]],"date-time":"2021-05-26T23:48:39Z","timestamp":1622072919000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/s13256-021-02892-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,27]]},"references-count":9,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["2892"],"URL":"https:\/\/doi.org\/10.1186\/s13256-021-02892-5","relation":{},"ISSN":["1752-1947"],"issn-type":[{"value":"1752-1947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,27]]},"assertion":[{"value":"18 February 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 May 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 May 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The surgical policy was explained preoperatively to the patients, and written informed consent was obtained. Overall study design was approved by the Ethical Committee of Kohnan Hospital 2019.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patients for publication of their case reports and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"289"}}