Gültekin BAŞ, Ahmet Toygar KALKAN, Göknur YORULMAZ
Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi - 2026;33(3):359-367
To systematically review the published cases of pregnancy-associated pituitary apoplexy and describe the clinical features, tumor types, treatment approaches, and pregnancy outcomes. This systematic review was conducted in accordance with the PRISMA guidelines. A comprehensive search was performed in PubMed and Google Scholar for studies published between 2000 and 2025 reporting cases of pituitary apoplexy occurring during pregnancy or the postpartum period. Seven studies met the inclusion criteria. Data were analyzed regarding demographic characteristics, tumor type, clinical presentation, treatment approach, and maternal-fetal outcomes. A total of 20 pregnant patients were identified. The mean age was 31.05 +/- 5.11 years, and the mean gestational age at diagnosis was 26.2 +/- 8.8 weeks. Prolactinoma was the most common tumor type (70%). Approximately 40% of patients underwent surgical treatment, while the remainder were managed medically. All mothers survived, with neurological improvement observed in most cases. Fetal outcomes were generally favorable, and no perinatal mortality was reported. Pregnancy-associated pituitary apoplexy is a rare clinical entity that most often develops in the context of prolactinoma. With appropriate medical or surgical management, maternal and fetal prognoses are generally good. Preconception counseling, careful dopamine agonist management, and multidisciplinary follow-up are crucial for women with pituitary adenomas planning pregnancy.
