Other Endocrine Emergencies in Pregnancy

  • Anita Singh
  • Shipra Singh


Endocrine emergencies in pregnancy are rare and are more likely to be missed in the absence of good obstetric care. Serious thyroid- and diabetes-related events in pregnancy are more common because of their higher prevalence in the normal population. Pituitary-, adrenal-, and parathyroid gland-related complications in pregnancy are now relatively rare. A high index of suspicion is needed for early diagnosis and treatment. A close liaison between an endocrinologist, maternal-fetal specialist, and intensivist is critical in optimizing both maternal and fetal outcomes.


Pituitary Adenoma Adrenal Insufficiency Hypertensive Crisis Adrenal Adenoma Tumor Enlargement 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Schnatz PF, Curry SL. Primary hyperparathyroidism in pregnancy: evidence-based management. Obstet Gynecol Surv. 2002;57:365–76.CrossRefPubMedGoogle Scholar
  2. 2.
    Kelly TR. Primary hyperparathyroidism during pregnancy. Surgery. 1991;110:1028–34.PubMedGoogle Scholar
  3. 3.
    Croom RD, Thomas CG. Primary hyperparathyroidism during pregnancy. Surgery. 1984;96:1109–18.PubMedGoogle Scholar
  4. 4.
    Clarke D, Seeds JW, Cefalo RC. Hyperparathyroid crisis and pregnancy. Am J Obstet Gynecol. 1981;140:840–2.Google Scholar
  5. 5.
    Matthias GS, Helliwell TR, Williams A. Postpartum hyperparathyroid crisis: cases report. Br J Obstet Gynaecol. 1987;94:807–10.CrossRefPubMedGoogle Scholar
  6. 6.
    Negishi H, Kobayashi M, Nishida R, et al. Primary hyperparathyroidism and simultaneous bilateral fracture of the femoral neck during pregnancy. J Trauma. 2002;52:367–9.CrossRefPubMedGoogle Scholar
  7. 7.
    Hess HM, Dickson J, Fox HE. Hyperfunctioning parathyroid carcinoma presenting as acute pancreatitis in pregnancy. J Reprod Med. 1980;25:83–7.PubMedGoogle Scholar
  8. 8.
    Kristoffersson A, Dahlgren S, Lithner F, Jarhult J. Primary hyperparathyroidism in pregnancy. Surgery. 1985;97:326–30.PubMedGoogle Scholar
  9. 9.
    Shangold MM, Dor N, Welt SI, et al. Hyperparathyroidism and pregnancy: a review. Obstet Gynecol Surv. 1982;37:217–28.CrossRefPubMedGoogle Scholar
  10. 10.
    Wagner G, Transhol L, Melchior JC. Hyperparathyroidism and pregnancy. Acta Endocrinol. 1964;47:549–64.PubMedGoogle Scholar
  11. 11.
    Central Brain Tumor Registry of the United States (CBTRUS). Statistical report: primary brain tumors in the US 1997–2001. Available at: Accessed 8 Apr 2005.
  12. 12.
    Goluboff LG, Ezrin C. Effect of pregnancy on the somatotroph and the prolactin cell of the human adenohypophysis. J Clin Endocrinol Metab. 1969;29:1533–8.CrossRefPubMedGoogle Scholar
  13. 13.
    Scheithauer BW, Sano T, Kovacs KT, et al. The pituitary gland in pregnancy: a clinicopathologic and immunohistochemical study of 69 cases. Mayo Clin Proc. 1990;65:461–74.CrossRefPubMedGoogle Scholar
  14. 14.
    Rigg LA, Lein A, Yen SSC. Pattern of increase in circulating prolactin levels during human gestation. Am J Obstet Gynecol. 1977;129:454–6.PubMedGoogle Scholar
  15. 15.
    Elster AD, Sanders TG, Vines FS, Chen MYN. Size and shape of the pituitary gland during pregnancy and postpartum: measurement with MR imaging. Radiology. 1991;181:531–5.CrossRefPubMedGoogle Scholar
  16. 16.
    Dinc H, Essen F, Demircy A, et al. Pituitary dimensions and volume measurements in pregnancy and postpartum: MR assessment. Acta Radiol. 1998;39:64–9.PubMedGoogle Scholar
  17. 17.
    Kupersmith MJ, Rosenberg C, Kleinberg D. Visual loss in pregnant women with pituitary adenomas. Ann Intern Med. 1994;121:473–7.CrossRefPubMedGoogle Scholar
  18. 18.
    Rossi AM, Vilska S, Heinonen PK. Outcome of pregnancies in women with treated or untreated hyperprolactinemia. Eur J Obstet Gynecol Reprod Biol. 1995;63:143–6.CrossRefPubMedGoogle Scholar
  19. 19.
    Musolino NRC, Bronstein MD. Prolactinomas and pregnancy. In: Bronstein MD, editor. Pituitary tumors and pregnancy. Norwell: Kluwer Academic Publishers; 2001. p. 91–108.CrossRefGoogle Scholar
  20. 20.
    Molitch ME. Pregnancy and the hyperprolactinemic women. N Engl J Med. 1985;312:1364–70.CrossRefPubMedGoogle Scholar
  21. 21.
    Liu C, Tyrrell JB. Successful treatment of a large macroprolactinoma with cabergoline during pregnancy. Pituitary. 2001;4:179–85.CrossRefPubMedGoogle Scholar
  22. 22.
    Molitch ME. Clinical manifestations of acromegaly. Endocrinol Metab Clin North Am. 1992;21:597–614.PubMedGoogle Scholar
  23. 23.
    Herman-Bonert V, Seliverstow M, Melmed S. Pregnancy in acromegaly: successful therapeutic outcome. J Clin Endocrinol Metab. 1998;83:727–31.PubMedGoogle Scholar
  24. 24.
    Beckers A, Stevenaert A, Foidart J-M, et al. Placental and pituitary growth hormone secretion during pregnancy in acromegalic women. J Clin Endocrinol Metab. 1990;71:725–31.CrossRefPubMedGoogle Scholar
  25. 25.
    Lindsay JR, Jonklass J, Oldfield EH, Nieman LK. Cushing’s syndrome during pregnancy: personal experience and review of the literature. J Clin Endocrinol Metab. 2005;90:3077–83.CrossRefPubMedGoogle Scholar
  26. 26.
    Aron DC, Schnall AM, Sheeler LR. Cushing’s syndrome and pregnancy. Am J Obstet Gynecol. 1990;162(1):244–52.CrossRefPubMedGoogle Scholar
  27. 27.
    Guilhaume B, Sanson ML, Villaud L, et al. Cushing’s syndrome and pregnancy: aetiologies and prognosis in 22 patients. Eur J Med. 1992;1:83–9.PubMedGoogle Scholar
  28. 28.
    Bevan JS, Gough MH, Gillmer MD, Burke CW. Cushing’s syndrome in pregnancy; the timing of definitive treatment. Clin Endocrinol Oxf. 1987;27:225–33.CrossRefPubMedGoogle Scholar
  29. 29.
    Madhun ZT, Aron DC. Cushing’s disease in pregnancy. In: Bronstein MD, editor. Pituitary tumors and pregnancy. Norwell: Kluwer Academic Publishers; 2001. p. 149–72.CrossRefGoogle Scholar
  30. 30.
    Brodsky JB, Cohen EN, Brown Jr BW, et al. Surgery during pregnancy and fetal outcome. Am J Obstet Gynecol. 1980;138:1165–7.PubMedGoogle Scholar
  31. 31.
    Sheehan HL, Davis JC. Pituitary necrosis. Br Med Bull. 1968;24:59–70.Google Scholar
  32. 32.
    Kelestimur F. Sheehan’s syndrome. Pituitary. 2003;6:181–8.CrossRefPubMedGoogle Scholar
  33. 33.
    Feinberg E, Molitch M, Peaceman A. Frequency of Sheehan’s syndrome. Fertil Steril. 2005;84:975–9.CrossRefPubMedGoogle Scholar
  34. 34.
    Sheehan HL. The neurohypophysis in post-partum hypopituitarism. J Pathol Bacteriol. 1963;85:145–69.CrossRefPubMedGoogle Scholar
  35. 35.
    Osler M, Pedersen J. Pregnancy in a patient with Addison’s disease and diabetes mellitus. Acta Endocrinol. 1962;4:79–87.Google Scholar
  36. 36.
    O’Shaughnessy RW, Hackett KJ. Maternal Addison’s disease and fetal growth retardation: a case report. J Reprod Med. 1984;29(10):752–6.PubMedGoogle Scholar
  37. 37.
    Okawa T, Asano K, Hashimoto T, et al. Diagnosis and management of primary aldosteronism in pregnancy: case report and review of the literature. Am J Perinatol. 2002;19(1):31–6.CrossRefPubMedGoogle Scholar
  38. 38.
    Crane MG, Andes JP, Harris JJ, et al. Primary aldosteronism in pregnancy. Obstet Gynecol. 1964;23:200–8.PubMedGoogle Scholar
  39. 39.
    Fujiyama S, Mori Y, Matsubara H, et al. Primary aldosteronism with aldosterone-producing adrenal adenoma in a pregnant woman. Intern Med. 1999;38(1):36–9.CrossRefPubMedGoogle Scholar
  40. 40.
    Botchan A, Hauser R, Kutfermine M, et al. Pheochromocytoma in pregnancy: case report and review of the literature. Obstet Gynecol Surv. 1995;50(4):321–7.CrossRefPubMedGoogle Scholar
  41. 41.
    Lyman DJ. Paroxysmal hypertension, pheochromocytoma, and pregnancy. J Am Board Fam Pract. 2002;15(2):153–8.PubMedGoogle Scholar
  42. 42.
    Cermakova A, Knibb AA, Hoskins C, et al. Post partum phaeochromocytoma. Int J Obstet Anesth. 2003;12(4):300–4.CrossRefPubMedGoogle Scholar
  43. 43.
    Harper MA, Murnaghan GA, Kennedy L, et al. Phaeochromocytoma in pregnancy: five cases and a review of the literature. Br J Obstet Gynaecol. 1989;96(5):594–606.CrossRefPubMedGoogle Scholar
  44. 44.
    Lenders JW, Pacak K, Eisnhofer G. New advances in the biochemical diagnosis of pheochromocytoma: moving beyond catecholamines. Ann N Y Acad Sci. 2002;970:29–40.CrossRefPubMedGoogle Scholar
  45. 45.
    Ilias I, Pacak K. Current approaches and recommended algorithm for the diagnostic localization of pheochromocytoma. J Clin Endocrinol Metab. 2004;89(2):479–91.CrossRefPubMedGoogle Scholar
  46. 46.
    Devoe LD, O’Dell BE, Castillo RA, et al. Metastatic pheochromocytoma in pregnancy and fetal biophysical assessment after maternal administration of alpha-adrenergic, beta adrenergic, and dopamine antagonists. Obstet Gynecol. 1986;68(Supll 3):S15–8.Google Scholar
  47. 47.
    Strachan AN, Claydon P, Caunt JA. Phaeochromocytoma diagnosed during labour. Br J Anaesth. 2000;85(4):635–7.CrossRefPubMedGoogle Scholar

Copyright information

© Springer India 2016

Authors and Affiliations

  1. 1.Department of Obstetrics and GynaecologyPatna Medical CollegePatnaIndia
  2. 2.Jyoti Punj HospitalPatnaIndia

Personalised recommendations