Prolactinoma Background in Pituitary Apoplexy in Pregnancy: A Meta-Analytic Evaluation

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BAŞ G., Kalkan A. T., Yorulmaz G.

Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi, cilt.33, sa.3, ss.359-367, 2026 (TRDizin)

Özet

To systematically review the published cases of preg- nancy-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 preg- nancy or the postpartum period. Seven studies met the inclusion criteria. Data were analyzed regarding demographic characteristics, tumor type, clinical pre- sentation, 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 ges- tational age at diagnosis was 26.2 ± 8.8 weeks. Pro- lactinoma was the most common tumor type (70%). Approximately 40% of patients underwent surgical treatment, while the remainder were managed medi- cally. All mothers survived, with neurological improve- ment 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 gen- erally good. Preconception counseling, careful dopa- mine agonist management, and multidisciplinary fol- low-up are crucial for women with pituitary adenomas planning pregnancy.