Pregnancies are rare in women with pituitary adenomas, which may relate to hormone excess from secretory subtypes such as prolactinomas or corticotroph adenomas. Decreased fertility may also result from pituitary hormone deficiencies due to compression of the gland by large tumours and/or surgical or radiation treatment of the lesion. Counselling premenopausal women with pituitary adenomas about their chance of conceiving spontaneously or with assisted reproductive technology, and the optimal pre-conception treatment, should start at the time of initial diagnosis. The normal physiological changes during pregnancy need to be considered when interpreting endocrine tests in women with pituitary adenomas. Dose adjustments in hormone substitution therapies may be needed across the trimesters. When medical therapy is used for pituitary hormone excess, consideration should be given to the known efficacy and safety data specific to pregnant women for each therapeutic option. In healthy women, pituitary gland size increases during pregnancy. Since some pituitary adenomas also enlarge during pregnancy, there is a risk of visual impairment, especially in women with macroadenomas or tumours near the optic chiasm. Pituitary apoplexy represents a rare acute complication of adenomas requiring surveillance, with surgical intervention needed in some cases. This guideline describes the choice and timing of diagnostic tests and treatments from the pre-conception stage until after delivery, taking into account adenoma size, location and endocrine activity. In most cases, pregnant women with pituitary adenomas should be managed by a multidisciplinary team in a centre specialised in the treatment of such tumours.

中文翻译：

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关于妊娠期功能性和无功能性垂体腺瘤的 ESE 临床实践指南。

患有垂体腺瘤的女性很少怀孕，这可能与分泌亚型（如催乳素瘤或促肾上腺皮质激素腺瘤）的激素过多有关。由于大肿瘤压迫腺体和/或病变的手术或放射治疗，垂体激素缺乏也可能导致生育能力下降。应在初次诊断时开始向患有垂体腺瘤的绝经前妇女提供有关自然受孕或辅助生殖技术受孕机会以及最佳受孕前治疗的咨询。在解释患有垂体腺瘤的女性的内分泌检查时，需要考虑怀孕期间的正常生理变化。在整个孕期可能需要调整激素替代疗法的剂量。当药物治疗垂体激素过多时，对于每种治疗选择，都应考虑孕妇特有的已知功效和安全性数据。在健康女性中，垂体的大小在怀孕期间会增加。由于一些垂体腺瘤在怀孕期间也会增大，因此存在视力受损的风险，尤其是患有大腺瘤或视交叉附近肿瘤的女性。垂体卒中是一种罕见的腺瘤急性并发症，需要监测，在某些情况下需要手术干预。本指南描述了从受孕前到分娩后诊断测试和治疗的选择和时间安排，同时考虑了腺瘤的大小、位置和内分泌活动。大多数情况下，