Abstract
Acromegaly complicating pregnancy is rare.Glucose intolerance occurs in 50% of patients with acromegaly, sodium retention leads to hypertension in 25-35% of patients,with potential for exacerbation in pregnancy. ctreotide is a synthetic octapeptide of somatostatin,with plasma half-life of about 90 minutes, vs 2-6 minutes of somatostatin.We carried out a monitoring and a treatment with Octretide of a 36-year-old woman,nulliparous, with active acromegaly despite doublé pituitary surgery.US imaging of fetal development has been performed, since the 10th till the 38th week.Eco-color-doppler has been used to examine the umbilical and uterine arteries at 16,29,33,36 weeks, in agreement to octreotide infusion.The Doppler flow imaging has been made at beginning of headache,so that has been recorded placenta and uterine flow before and during and after octreotide infusion,till clearing up of headache.The comparison of uterine artery flussimetry show a statistical significant difference between the pre-OCT and post-OCT systolic velocity peak (P < 0.0001) and end diastolic velocity peak (P < 0.0005).The pregnancy was uneventful for both mother and fetus.Have been described the cases of women with acromegaly treated with octreotide during pregnancy.No malformations were noted but because of limited data, the use of somatostatin analogs cannot be recommended for use during pregnancy except under extraordinary circumstances.
Riassunto
Acromegaly complicating pregnancy is rare.Glucose intolerance occurs in 50% of patients with acromegaly, sodium retention leads to hypertension in 25-35% of patients,with potential for exacerbation in pregnancy. ctreotide is a synthetic octapeptide of somatostatin,with plasma half-life of about 90 minutes, vs 2-6 minutes of somatostatin.We carried out a monitoring and a treatment with Octretide of a 36-year-old woman,nulliparous, with active acromegaly despite doublé pituitary surgery.US imaging of fetal development has been performed, since the 10th till the 38th week.Eco-color-doppler has been used to examine the umbilical and uterine arteries at 16,29,33,36 weeks, in agreement to octreotide infusion.The Doppler flow imaging has been made at beginning of headache,so that has been recorded placenta and uterine flow before and during and after octreotide infusion,till clearing up of headache.The comparison of uterine artery flussimetry show a statistical significant difference between the pre-OCT and post-OCT systolic velocity peak (P < 0.0001) and end diastolic velocity peak (P < 0.0005).The pregnancy was uneventful for both mother and fetus.Have been described the cases of women with acromegaly treated with octreotide during pregnancy.No malformations were noted but because of limited data, the use of somatostatin analogs cannot be recommended for use during pregnancy except under extraordinary circumstances.