Pituitary Diseases During Pregnancy

Martin N. Montoro, MD, and Jorge H. Mestman, MD

Changes In The Normal Anterior Pituitary Gland During Pregnancy

Anatomic and functional changes take place in the pituitary gland during pregnancy that have to be taken into consideration to properly evaluate its function, and particularly to diagnose pituitary disorders during pregnancy.

The various anterior pituitary hormonesprolactin (PRL), thyroxine-stimulating hormone (TSH), luteinizing hormone (LH) and follicle-stimulating hormone (FSH), corticotropin (ACTH), and growth hormone (GH) are released into the systemic circulation in response to stimulating or inhibiting messages from hypothalamic peptide hormones. These peptides reach the pituitary gland through the portal circulation. Thus far several have been identified; they include thyrotropin-releasing hormone (TRH), gonadotropin-releasing hormone GnRH), corticotropin-releasing factor (CRF), growth hormone-releasing factor (GHRF), somatostatin (somatotropin release-inhibiting factor [SRIF]) and more recently, a GnRH-associated peptide (GAP) that inhibits prolactin secretion. Dopamine, a biogenic amine, also inhibits PRL secretion. Communications between the hypothalamus and the higher centers of the brain are accomplished by a variety of neurotransmitters, which include the already mentioned dopamine, serotonin, y-aminobutiric acid (GABA), norepinephrine and various opioid peptides, as well as many of the peptides also found in the intestinal tract.

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