Atlanta Perinatal Associates
Patient Education

Pituitary Adenoma
in Pregnancy

Understanding your condition and what to expect

Maternal-Fetal Medicine  ·  Atlanta Perinatal Associates

🧠
What Is This?

Pituitary Adenoma

A benign (non-cancerous) growth on the pituitary gland — a pea-sized gland at the base of your brain that controls important hormones.

Not cancer  ✓
Background

Your Pituitary Gland
During Pregnancy

📈

70–120%

Normal increase in pituitary volume during pregnancy

🔬

Estrogen

The pregnancy hormone that drives this normal enlargement

Normal

This enlargement is a healthy, expected part of pregnancy

Types

Types of Pituitary Adenomas

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Prolactinoma

Most common type. Produces extra prolactin (a milk hormone).

Non-Functioning

Does not produce excess hormones. Generally lower risk in pregnancy.

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Other Types

Rare. Include ACTH- or GH-secreting tumors. Require specialist care.

Risk Stratification

Size Matters

🟢

Microadenoma

Smaller than 10 mm

Risk of growth: < 5%

Low risk. Close monitoring is usually all that is needed.

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Macroadenoma

10 mm or larger

Risk of growth: 20–31%

Requires more frequent monitoring during pregnancy.

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Medication

Your Medication
During Pregnancy

Dopamine agonist medications (e.g., cabergoline, bromocriptine) are typically stopped at conception to minimize fetal exposure.

Your MFM specialist will guide you on when — and whether — to restart after delivery.

Monitoring

What We Watch For

Every Visit
Ask about headaches and vision changes
Every Trimester (Macroadenoma)
Visual field testing — checks your peripheral vision
If Symptoms Develop
MRI without contrast — safe in pregnancy, no radiation
Not Recommended
Serial prolactin blood tests — unreliable in pregnancy (levels rise 10-fold normally)
Action Items

Symptoms to Report Promptly

🤕

Headache

New, persistent, or worsening

👁️

Vision Changes

Blurring, double vision, or loss of side vision

Sudden Severe Headache

Go to the emergency room immediately

Most patients have no symptoms at all — but we want to know right away if you do.

Rare Complication

Pituitary Apoplexy
A Rare Emergency

What It Is

A sudden bleed or loss of blood supply inside the adenoma. Very uncommon.

Signs

"Thunderclap" headache, nausea, vision loss, or eye movement problems.

Outcome

Treatable. Most reported cases have excellent outcomes for mother and baby.

Call 911 or go to the ER for sudden severe headache
Labor & Delivery

Delivering Your Baby

🤱

Vaginal Delivery

Safe and appropriate for most women with pituitary adenomas.

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Cesarean Section

Reserved for standard obstetric reasons, not the adenoma itself.

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Stress-Dose Steroids

If your pituitary function is low, you will receive special medication during labor.

After Delivery

Postpartum Care

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Breastfeeding

Generally safe for micro- and stable macroadenomas. Discuss with your team.

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Restarting Medication

Usually resumed after breastfeeding ends, or sooner if the tumor grows.

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Follow-up MRI

Scheduled postpartum to assess tumor size and guide long-term management.

Summary

Risk at a Glance

Adenoma Type Growth Risk Key Action
Microprolactinoma (<10 mm) < 5% — Low Stop medication; clinical monitoring
Macroprolactinoma (≥10 mm) 20–31% — Moderate Monthly visual field exams; restart medication if growth
Resected Macroadenoma < 5% — Low Clinical monitoring; usually safe off medication
Non-Functioning (Micro) Very Low Routine prenatal care
Non-Functioning (Macro) Low–Moderate Visual field monitoring; MRI if symptoms
Common Questions

Questions We Often Hear

Will this harm my baby?
Most adenomas do not affect the baby. We monitor closely to keep both of you safe.

Can I have a normal pregnancy?
Yes. The majority of patients with pituitary adenomas have healthy pregnancies.

Do I need surgery during pregnancy?
Rarely. Surgery is reserved for significant, progressive vision loss that does not respond to medication.

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Our Commitment

We Are Your Partners

You are not alone. Our team — including your MFM specialist, endocrinologist, and neurosurgeon when needed — will work together to support a safe, healthy pregnancy.

Personalized care plan
Multidisciplinary team
Evidence-based monitoring

Atlanta Perinatal Associates  ·  Maternal-Fetal Medicine

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