Abstracts

Blurring of Vision in Pregnancy: Two Case Series in Hospital Sultanah Aminah, Johor Bahru

POB 26 / Obstetrics

Dr Simran Kaur, Dr Sureshkumar Subramaniam, Dr Eliza Mohd Noor, Dr J. Ravichandran
Hospital Sultanah Aminah, Johor Bahru

Pregnancy is associated with normal physiological changes in endocrine system. Lactotraph hyperplasia will cause the enlargement of pituitary gland, which may lead to hormone oversecretion and increased tumour size in pituitary adenoma. Pituitary tumour in pregnancy is rare; however serious event with significant morbidity and even possible mortality may occur if not recognized in time. First case, a 37-year-old woman, in her third pregnancy at third trimester, presented with bilateral asymmetrical hemianopia associated with headache since her second trimester. MRI brain was done, showed tuberculum sellar meningioma. Cabergolin was commenced however no improvement of the clinical condition. She underwent elective caesarean section at 35 weeks of gestation after completing one course of dexamethasone. One week later, craniotomy and tumour excision performed on her and noted tumour compressing the optic nerve. Post operatively, noted immediate improvement in her visual field. The subsequent case, a 27-year-old woman in her first pregnancy at 36 weeks gestation was admitted with bilateral hemianopia. MRI brain showed pituitary apoplexy with compression and displacement of the optic chiasm.  She was treated with corticosteroids and levothyroxine. Conservative approach was taken for this patient as her clinical picture was static. She underwent uneventful elective caesarean section at 38 weeks. Contrasted CT of the paranasal sinuses done 3 weeks postpartum showed sellar mass extending into suprasellar region. She has been planned for endoscopic transsphenoidal surgery in June 2017.