Prolactinoma causing visual disturbance in pregnancy - a multidisciplinary management conundrum

2019 ◽  
Author(s):  
Sultana Azam ◽  
Rebecca Scott ◽  
Chioma Izzi-Engbeaya ◽  
Sheba Jarvis ◽  
Suhaniya Samarasinghe ◽  
...  
Keyword(s):  
Visual Disturbance ◽  
Multidisciplinary Management ◽  
In Pregnancy

Subglottic tracheal stenosis complicating pregnancy: A case report

2021 ◽  
pp. 1753495X2199022
Author(s):  
Edward J Miller ◽  
Emily YS Huning
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Tracheal Stenosis ◽  
Multidisciplinary Management ◽  
Shortness Of Breath ◽  
Uncommon Case ◽  
In Pregnancy

The case presented details an uncommon case of subglottic tracheal stenosis exacerbated by pregnancy. We outine the multidisciplinary management involved and the outcomes for the pregnancy. The case serves as a reminder that shortness of breath in pregnancy has a broad differential diagnosis, and stridor is always abnormal.

scholarly journals A case of pituitary apoplexy in pregnancy

2014 ◽  
Vol 2014 ◽  
Author(s):  
Aimee R Hayes ◽  
Anthony J O'Sullivan ◽  
Mark A Davies
Keyword(s):  
Pituitary Apoplexy ◽  
Rare Event ◽  
Visual Disturbance ◽  
List Type ◽  
The Subject ◽  
Magnetic Resonance Imaging Mri ◽  
Evidence Of Impact ◽  
Learning Points ◽  
Visual Abnormalities ◽  
In Pregnancy

Summary Pituitary apoplexy is a rare event in pregnancy. A 41-year-old woman with a known pituitary microadenoma presented with visual disturbance and headache during the second trimester of pregnancy. Magnetic resonance imaging (MRI) demonstrated pituitary apoplexy with chiasmal compression. After treatment with corticosteroid therapy, she underwent transsphenoidal excision of the pituitary adenoma. Visual abnormalities were completely restored and pituitary function preserved. There was no evidence of impact on the foetus. The literature on the subject is reviewed with emphasis on the management of the apoplectic patient with mild and stable neuro-ophthalmological signs. Learning points There are no clear guidelines on the management of pituitary apoplexy in pregnancy. A multidisciplinary approach can minimise morbidity and mortality. Pituitary apoplexy has an unpredictable clinical course and determining which clinical situations warrant early surgery needs to take into consideration the presence and severity of neurological signs and their stability. The management of conscious apoplectic patients with absent or mild and stable neuro-ophthalmological signs is controversial.

scholarly journals Pregnancy after Prosthetic Aortic Valve Replacement: How Do We Monitor Prosthetic Valvular Function during Pregnancy?

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Nicole Sahasrabudhe ◽  
Nickolas Teigen ◽  
Diana S. Wolfe ◽  
Cynthia Taub
Keyword(s):  
Aortic Valve ◽  
Prenatal Care ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Modern Medicine ◽  
Multidisciplinary Management ◽  
Prosthetic Aortic Valve ◽  
Echocardiographic Parameters ◽  
Valvular Function ◽  
In Pregnancy

Background. With modern medicine, many women after structural heart repair are deciding to experience pregnancy. There is a need for further study to identify normal echocardiographic parameters to better assess prosthetic valvular function in pregnancy. In addition, a multidisciplinary approach is essential in managing pregnant patients with complex cardiac conditions.Case. A 22-year-old nulliparous woman with an aortic valve replacement 18 months prior to her pregnancy presented to prenatal care at 20-week gestation. During her prenatal care, serial echocardiography showed a significant increase in the mean gradient across the prosthetic aortic valve. Multidisciplinary management and a serial echocardiography played an integral role in her care that resulted in a successful spontaneous vaginal delivery without complications.Conclusion. Further characterization of the normal echocardiographic parameters in pregnant patients with prosthetic valves is critical to optimize prenatal care for this patient population. This case report is novel in that serial echocardiograms were obtained throughout prenatal care, which showed significant changes across the prosthetic aortic valve.Teaching Points.(1)Further study is needed to identify normal echocardiographic parameters to best assess prosthetic valvular function in pregnancy.(2)Multidisciplinary management is encouraged to optimize prenatal care for women with prosthetic aortic valve replacements.

scholarly journals Visual disturbance as primary symptom of pituitary apoplexy in pregnancy

2021 ◽  
Vol 3 (4) ◽  
pp. 244-249
Author(s):  
Norazlida Ibrahim ◽  
Raja Norliza Binti Raja Omar ◽  
Mae-Lynn Catherine Bastion
Keyword(s):  
Visual Field ◽  
Pituitary Apoplexy ◽  
Wide Spectrum ◽  
Brain Mri ◽  
Visual Field Loss ◽  
Optic Chiasm ◽  
Visual Disturbance ◽  
Mortality And Morbidity ◽  
Pituitary Lesion ◽  
In Pregnancy

Pituitary apoplexy in pregnancy is a potentially fatal condition caused by acute ischaemic infarction or haemorrhage of pre-existing pituitary adenoma or within a physiologically enlarged pituitary gland. It has a wide spectrum of clinical presentations ranging from a mild headache to sudden collapsed. Here, we report a life-threatening case of pituitary apoplexy in a non-functioning pituitary macroadenoma occurring during pregnancy that presented with bilateral blurring of vision. Visual field showed bitemporal superior quadrantanopia. Urgent non-contrast brain MRI revealed an acute expansion of a hemorrhagic pituitary lesion complicated with local compression to the optic chiasm. The patient underwent an uneventful right supraorbital craniotomy and excision of the tumour under general anaesthesia with no foetal loss. The repeated visual field at 2 weeks after surgery showed recovering visual field defect. Hence, early neurosurgical intervention is advisable to prevent mortality and morbidity due to permanent visual field loss.

Non-alcoholic fatty liver disease in pregnancy

2021 ◽  
pp. 1753495X2110347
Author(s):  
Charlotte S Benson ◽  
Jeremy F Cobbold ◽  
Charlotte J Frise
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Multidisciplinary Management ◽  
Liver Pathology ◽  
Alcoholic Fatty Liver ◽  
The Uk ◽  
Specific Symptoms ◽  
Alcoholic Fatty Liver Disease ◽  
In Pregnancy

Non-alcoholic fatty liver disease (NAFLD) is now the commonest liver pathology in the UK; however, relatively little is known about its course in pregnancy or the effect it has on maternal or fetal outcomes. Described here is a 24-year-old woman in her first pregnancy who presented with non-specific symptoms and raised alanine aminotransferase with ultrasonography of her liver showing changes of steatosis and suspicious for cirrhosis, leading to a diagnosis of NAFLD. The case illustrates the need for the clinician to have awareness of this increasingly prevalent condition and for multidisciplinary management.

scholarly journals Recurrent pituitary apoplexy in pregnancy

2021 ◽  
Vol 14 (8) ◽  
pp. e242353
Author(s):  
Franziska Geissler ◽  
Irene Hoesli ◽  
Monya Todesco Bernasconi
Keyword(s):  
Pituitary Adenoma ◽  
Pituitary Gland ◽  
Preterm Delivery ◽  
Pituitary Apoplexy ◽  
Signs And Symptoms ◽  
Visual Disturbance ◽  
Severe Headache ◽  
Altered Consciousness ◽  
Existing Data ◽  
In Pregnancy

Pituitary apoplexy is caused by haemorrhage or infarction of the pituitary gland. Presenting signs and symptoms often include severe headache, visual disturbance, ophthalmoplegia, altered consciousness and impaired pituitary function. The management of pituitary apoplexy has very rarely been described during pregnancy and there is no existing data for further pregnancies of affected women. We present a case of a woman with a recurrent pituitary apoplexy due to haemorrhages in a pituitary adenoma in her third and fourth pregnancies. In both pregnancies, the pituitary apoplexy was managed conservatively, but due to therapy-resistant headaches, a preterm delivery was implemented.

Acute Headache in Pregnancy

2017 ◽  
Author(s):  
M. Angela O’Neal
Keyword(s):  
Growth Hormone ◽  
Adrenocorticotropic Hormone ◽  
Pituitary Apoplexy ◽  
Optic Chiasm ◽  
Visual Disturbance ◽  
Electrolyte Imbalance ◽  
Clinical Feature ◽  
Acute Headache ◽  
Optic Nerve Involvement ◽  
In Pregnancy

The case illustrates the characteristics of pituitary apoplexy. This anatomy of the pituitary, which predisposes to the condition, is described. The most common clinical feature is headache. Visual disturbance related to optic chiasm or optic nerve involvement is also common. Pituitary apoplexy is a neuroendocrine emergency. The most important hormone involved is adrenocorticotropic hormone, ACTH. However, there are often multiple hormonal deficiencies: growth hormone, hypothyroidism, and hypogonadotropic deficiency. A high prolactin level may reflect a prolactinoma or be due to hypothalamic inhibition. Diabetes insipidus (DI) is also common. The most urgent issue in treating pituitary apoplexy is prompt assessment of fluid and electrolyte imbalance and the replacement of corticosteroids.

scholarly journals Acute pancreatitis with eclampsia-preeclampsia syndrome and poor maternal outcome: two case reports and review of literature

2015 ◽  
Vol 8 (3) ◽  
pp. 146-148 ◽  
Author(s):  
Shalini Gainder ◽  
Parul Arora ◽  
SC Saha ◽  
Lileswar Kaman
Keyword(s):  
Acute Pancreatitis ◽  
Maternal Mortality ◽  
Case Reports ◽  
Maternal Outcome ◽  
Multidisciplinary Management ◽  
Rare Entity ◽  
Review Of Literature ◽  
In Pregnancy

Acute pancreatitis in pregnancy is a rare entity and has been reported to be associated with preeclampsia in the literature. Fulminant pancreatitis may have a guarded prognosis despite intensive multidisciplinary management. Two cases of maternal mortality in women with acute pancreatitis noted in the setting of preeclampsia-eclampsia syndrome are reported here.

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