Minimally invasive pituitary surgery in a hemorrhagic necrosis of adenoma during pregnancy

A 29-year-old woman with a prolactin microadenoma was under good control with bromocriptine (BCP) therapy until she became pregnant, when the treatment was stopped. During the third trimester of pregnancy the patient presented a unilateral visual loss and intermittent headaches. BCP was restarted and one week later she developed a complete ophthalmoplegia on the other side. The patient was submitted to an endoscopic transnasal transeptal resection of a hematoma and tumoral tissue in the pituitary region. One month after surgery, at 39 weeks of gestation, the patient spontaneously delivered a healthy girl weighing 3 kg, with an Apgar score of 9 and 10 at five minutes. This is the first case in the literature of a pregnant woman with second and third cranial nerve lesions, submitted to minimally invasive neuroendoscopic transnasal transsphenoidal approach in the third trimester of pregnancy.Gen Hosp, Dept Neurosurg, Fortaleza, Ceara, BrazilGen Hosp, Dept Otorhinolaryngol, Fortaleza, Ceara, BrazilFed Univ Ceara, Dept Anesthesiol, Fortaleza, Ceara, BrazilUniv Fed Sao Paulo, Dept Neurosurg, Sao Paulo, BrazilUniv Fed Sao Paulo, Dept Neurosurg, Sao Paulo, BrazilWeb of Scienc