Successful pregnancy in an acromegalic woman treated with octreotide

Takeuchi, Kyousuke; Funakoshi, Toru; Oomori, Shinya; Maruo, Takeshi

doi:10.1016/s0029-7844(98)00461-x

Cited by 30 publications

(24 citation statements)

References 3 publications

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“…11 Octreotide exhibits pharmacologic effects similar to the natural hormone somatostatin, including secretory inhibition of some anterior pituitary hormones, suppression of pancreatic endocrine and exocrine function, inhibition of gastric acid and gastrointestinal hormone secretion, and suppression of serotonin secretion. 12 Currently, intramuscular injections of long-acting octreotide (instead of regular octreotide) are used in the treatment of chronic carcinoid symptoms. 13 Octreotide levels rise sharply after the first injection but subsequently fall, reaching a nadir at about seven days, then rise slowly reaching a plateau at 14 days, and remain elevated for the entire month.…”

Section: Discussionmentioning

confidence: 99%

Carcinoid tumor and intravenous octreotide infusion during labor and delivery

Bharadwaj

Malinow

2009

International Journal of Obstetric Anesthesia

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Section: Discussionmentioning

confidence: 99%

Carcinoid tumor and intravenous octreotide infusion during labor and delivery

Bharadwaj

Malinow

2009

International Journal of Obstetric Anesthesia

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“…Of note, four of them had acromegaly diagnosed during gestation, and the reasons for surgery were increased intracranial pressure (48), apoplexy (53) and visual loss (3,58,60,63). A few other cases with mass effect symptoms during pregnancy were medically managed with bromocriptine, octreotide or glucocorticoid (3,54,55,56,64). Accordingly, the overall risk of tumor growth during pregnancy is relatively low, around 10% (3), and the risk of a clinically relevant growth is even smaller.…”

Section: Effect Of Pregnancy On Tumor Growth In Acromegalymentioning

confidence: 99%

“…Although octreotide crosses placental barrier and placenta has somatostatin receptors that bind octreotide (78), no serious adverse fetal outcomes have been detected in nearly 50 (2,3,4,5,7,36,38,47,48,50,51,55,57,63,79,80,81,82,83,84) cases of transient exposure (mostly in first trimester) nor in a much smaller number of continuous exposure to somatostatin analogs (SA) and/or dopaminergic agonists (4,64,73,75,78,85,86,87). Notwithstanding, concerns about low birth weight associated to fetal exposure to SA either alone or, as more often reported, in combination with dopaminergic agonists (DA) have been raised by a large retrospective study and by few case reports (3,4,85,88).…”

Section: Effect Of Acromegaly and Its Treatment On Fetal Developmentmentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Acromegaly and pregnancy: a contemporary review

Abucham

Bronstein

Rodrigues

2017

European Journal of Endocrinology

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Although fertility is frequently impaired in women with acromegaly, pregnancy is apparently becoming more common due to improvement in acromegaly treatment as well as in fertility therapy. As a result, several studies on pregnancy in patients with acromegaly have been published in recent years adding new and relevant information to the preexisting literature. Also, new GH assays with selective specificities and the knowledge of the expression of the various GH genes have allowed a better understanding of somatotrophic axis function during pregnancy. In this review, we show that pregnancy in women with acromegaly is generally safe, usually with tumoral and hormonal stability. Although the paucity of data limits evidence-based recommendations for preconception counseling and pregnancy surveillance, controlling tumor size and hormonal activity before pregnancy is highly recommended to ensure better outcomes, and surgical control should be attempted when feasible. Treatment interruption at pregnancy confirmation has also proven to be safe, as drugs are not formally allowed to be used during pregnancy. Drug exposure (somatostatin analogs) during early or whole pregnancy might increase the chance of a lower birth weight. Aggressive disease is uncommon and may urge individual decisions such as surgery or drug treatment during pregnancy or lactation.Correspondence should be addressed to J Abucham

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“…No visual field defects developed in our patients, but they had all been previously operated and all tumor remnants were distant from the optic chiasm. Tumor enlargement after octreotide withdrawal (34), tumor apoplexy (35,36), aggressive tumors (37), and untreated acromegaly (38,39,40,41) may determine a less favorable visual outcome during pregnancy.…”

Section: Tumor Growthmentioning

confidence: 99%

Acromegaly and pregnancy: a prospective study

Rodrigues¹,

Boguszewski²,

Gadelha³

et al. 2014

European Journal of Endocrinology

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Context and objective: The interaction between pregnancy and acromegaly has been studied only retrospectively. We used prospective data to assess those interactions. Design: Prospective, interventional, multicentric study. Patients: Ten pregnancies in eight acromegalic patients were included according to the following criteria: previous diagnosis of acromegaly; and active acromegaly before pregnancy. Sellar magnetic resonance image (MRI), GH, and IGF1 measurements were carried out before pregnancy. The exclusion criterion was radiotherapy. Intervention: Withdrawal of pharmacological treatment (octreotide and/or cabergoline and/or pegvisomant) following pregnancy diagnosis. Main outcome measures: Clinical/biochemical evaluations throughout pregnancy/puerperium and sellar MRI after delivery; and GH and IGF1 measurements before pregnancy. GH was measured by an interference-free IFMA assay during pregnancy and IGF1 by measured by Immulite 2000 assay in patients and 64 control pregnancies. Results: No tumor growth was observed. Nine deliveries were at term and one at 35 weeks (preeclampsia). All newborns were healthy. Mean IGF1 levels before and during pregnancy were similar, but increased significantly during puerperium. As IGF1 in controls increased after midgestation, the prevalence of controlled IGF1 rose significantly from 2/10 (!20 weeks) to 9/10 (O30 weeks). Diabetes mellitus and hypertension/preeclampsia developed in one patient in each group; both complications were nonsignificantly (PZ0.06) associated with IGF1 O1.3 ULN before pregnancy. Conclusions: Acromegaly control usually improved and tumor growth was not stimulated during pregnancy in spite of withdrawal of drug treatment. Drug treatment can be discontinued in most patients. Uncontrolled disease before pregnancy may pose a higher risk for diabetes and hypertension.

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Successful pregnancy in an acromegalic woman treated with octreotide

Cited by 30 publications

References 3 publications

Carcinoid tumor and intravenous octreotide infusion during labor and delivery

Carcinoid tumor and intravenous octreotide infusion during labor and delivery

MANAGEMENT OF ENDOCRINE DISEASE: Acromegaly and pregnancy: a contemporary review

Acromegaly and pregnancy: a prospective study

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