PDF(Pubmed)
Abstract：
Non-functioning pituitary adenomas (NFPAs) are rare in females of reproductive age. We present the case of a 37-year-old pregnant woman in her second trimester with a diagnosis of symptomatic pituitary macroadenoma with twin pregnancy. Magnetic resonance imaging (MRI) confirmed a well-defined macroadenoma compressing the optic chiasm, thus necessitating surgery. The patient underwent transnasal transsphenoidal resection of the tumor under general anesthesia. Anesthesia management posed challenges due to concurrent considerations of pregnancy and neurosurgery. Induction, maintenance, monitoring, and fluid management were carefully performed. The patient experienced a transient decrease in oxygen saturation, which improved with lung recruitment maneuvers. The surgery was successful without any complications. Postoperatively, an ophthalmology consultation was done, which showed an improvement in the patient\'s vision, as evidenced by the perimetry findings. Later, she delivered healthy twins at 36 weeks and six days of gestation. This case highlights the importance of a multidisciplinary approach and meticulous anesthetic management when dealing with pregnant patients undergoing non-obstetric surgery, ensuring optimal maternal-fetal perfusion and minimizing risks to both the mother and the fetus.
摘要：
无功能垂体腺瘤（NFPA）在育龄女性中很少见。我们介绍了一名37岁的孕妇在中期妊娠，诊断为双胎妊娠的有症状的垂体大腺瘤。磁共振成像（MRI）证实了一个明确的大腺瘤压缩视交叉，因此需要手术。患者在全身麻醉下接受了经鼻蝶入路肿瘤切除术。由于同时考虑妊娠和神经外科手术，麻醉管理提出了挑战。感应,维护,监测,和液体管理被仔细地执行。患者经历了氧饱和度的短暂下降，随着肺部募集动作的改善。手术成功，没有任何并发症。术后,进行了眼科咨询，这表明病人的视力有所改善，如视野检查结果所证明。稍后，她在怀孕36周零6天时产下了健康的双胞胎。这个案例突出了多学科的方法和细致的麻醉管理的重要性，当处理怀孕患者接受非产科手术时，确保最佳的母胎灌注，并最大程度地减少对母亲和胎儿的风险。
