J Korean Med Sci.  2010 May;25(5):794-797. 10.3346/jkms.2010.25.5.794.

Antepartum Pituitary Necrosis Occurring In Pregnancy with Uncontrolled Gestational Diabetes Mellitus: A Case Report

• Park HJ
• Kim J
• Rhee Y
• Park YW
• Kwon JY

• KMID: 1713969
• DOI: http://doi.org/10.3346/jkms.2010.25.5.794

Abstract

Antepartum pituitary necrosis is a rare medical condition that has only been reported in pregnant women with type I diabetes attributable to diabetes-related vasculopathy and hypercoagulability. We present for the first time a case of antepartum pituitary necrosis occurring in an uncontrolled gestational diabetes mellitus (GDM) patient. The patient was a 32-yr-old woman at 33 weeks and 2 days of gestation. She suffered from severe headache, blurred vision, dizziness, and vomiting. Her baby was delivered by Cesarean section. The brain magnetic resonance images revealed pituitary necrosis. This suggests that pituitary gland necrosis may also complicate GDM pregnancy when glucose levels are uncontrolled.

Keyword

Antepartum; Pituitary Necrosis; Diabetes, Gestational; Uncontrolled Hyperglycemia; Headache

MeSH Terms

Adult
Diabetes, Gestational/*diagnosis
Female
Humans
Necrosis/complications/pathology
Pituitary Gland/*pathology
Pregnancy

Figure

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  Fig. 1 Fetal tococardiogram demonstrating non-reassuring heart rate pattern on admission (top) and before emergency cesarean section (bottom). Multiple, repetitive mild to severe variable decelerations were revealed, suggesting fetal distress.

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  Fig. 2 (A) Unenhanced midline sagittal T1-weighted MR image shows low signal intensity of the enlarged anterior pituitary gland. (B) Unenhanced coronal T2-weighted MR image demonstrates heterogeneous signal intensity of the enlarged anterior pituitary gland. (C) Gadolinium-enhanced sagittal T1-weighted MR image shows the nonenhanced portion in the center of the gland, consistent with pituitary necrosis.

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  Fig. 3 Follow-up MR imaging at 2 months postpartum. (A) Coronal T2-weighted and (B) gadolinium-enhanced sagittal T1-weighted MR images show significant pituitary gland shrinkage.

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