{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T08:17:42Z","timestamp":1793089062439,"version":"4.5.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","issue":"3","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,9,1]]},"abstract":"<jats:p>Pregnancies are rare in women with pituitary adenomas, which may relate to hormone excess from secretory subtypes such as prolactinomas or corticotroph adenomas. Decreased fertility may also result from pituitary hormone deficiencies due to compression of the gland by large tumours and\/or surgical or radiation treatment of the lesion. Counselling premenopausal women with pituitary adenomas about their chance of conceiving spontaneously or with assisted reproductive technology, and the optimal pre-conception treatment, should start at the time of initial diagnosis. The normal physiological changes during pregnancy need to be considered when interpreting endocrine tests in women with pituitary adenomas. Dose adjustments in hormone substitution therapies may be needed across the trimesters. When medical therapy is used for pituitary hormone excess, consideration should be given to the known efficacy and safety data specific to pregnant women for each therapeutic option. In healthy women, pituitary gland size increases during pregnancy. Since some pituitary adenomas also enlarge during pregnancy, there is a risk of visual impairment, especially in women with macroadenomas or tumours near the optic chiasm. Pituitary apoplexy represents a rare acute complication of adenomas requiring surveillance, with surgical intervention needed in some cases. This guideline describes the choice and timing of diagnostic tests and treatments from the pre-conception stage until after delivery, taking into account adenoma size, location and endocrine activity. In most cases, pregnant women with pituitary adenomas should be managed by a multidisciplinary team in a centre specialised in the treatment of such tumours.<\/jats:p>","DOI":"10.1530\/eje-21-0462","type":"journal-article","created":{"date-parts":[[2021,8,23]],"date-time":"2021-08-23T08:34:30Z","timestamp":1629707670000},"page":"G1-G33","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-7","source":"Crossref","is-referenced-by-count":98,"title":["ESE Clinical Practice Guideline on functioning and nonfunctioning pituitary adenomas in pregnancy"],"prefix":"10.1093","volume":"185","author":[{"given":"A","family":"Luger","sequence":"first","affiliation":[{"name":"1Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L H A","family":"Broersen","sequence":"additional","affiliation":[{"name":"2Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N R","family":"Biermasz","sequence":"additional","affiliation":[{"name":"3Division of Endocrinology, Department of Medicine, Pituitary Center and Center for Endocrine Tumors, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B M K","family":"Biller","sequence":"additional","affiliation":[{"name":"4Neuroendocrine & Pituitary Tumor Clinical Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Buchfelder","sequence":"additional","affiliation":[{"name":"5Department of Neurosurgery, University Hospital Erlangen, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Chanson","sequence":"additional","affiliation":[{"name":"6Universit\u00e9 Paris-Saclay, Inserm, Physiologie et Physiopathologie Endocriniennes, Assistance Publique-H\u00f4pitaux de Paris, H\u00f4pital Bic\u00eatre, Service d\u2019Endocrinologie et des Maladies de la Reproduction et Centre de R\u00e9ference des Maladies Rares de l\u2019Hypophyse, Le Kremlin-Bic\u00eatre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J O L","family":"Jorgensen","sequence":"additional","affiliation":[{"name":"7Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Kelestimur","sequence":"additional","affiliation":[{"name":"8Department of Endocrinology, Yeditepe University, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Llahana","sequence":"additional","affiliation":[{"name":"9School of Health Sciences, City, University of London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Maiter","sequence":"additional","affiliation":[{"name":"10Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Universit\u00e9 Catholique de Louvain, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Mintziori","sequence":"additional","affiliation":[{"name":"11Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki Medical School, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Petraglia","sequence":"additional","affiliation":[{"name":"12Department of Obstetrics and Gynecology, University of Florence, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Verkauskiene","sequence":"additional","affiliation":[{"name":"13Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S M","family":"Webb","sequence":"additional","affiliation":[{"name":"14IIB-Sant Pau and Department of Endocrinology\/Medicine, Hospital Sant Pau, Universitat Aut\u00f3noma de Barcelona, and Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Raras (CIBER-ER, Unit 747), ISCIII, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O M","family":"Dekkers","sequence":"additional","affiliation":[{"name":"15Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands"},{"name":"16Department of Clinical Endocrinology, Leiden University Medical Center, Leiden, The Netherlands"},{"name":"17Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","container-title":["European Journal of 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