Q:

Should we regularly do MRI in pregnancy?

waelhammad
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2022-11-18
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A woman 31 years of age who is a follow-up case of acromegaly comes to the endocrinology outpatient department for follow-up. She was operated about 5 years back after which she was subjected to radiotherapy because of the residual lesion and persistently high postoperative growth hormone levels of 10 ng/mL and high levels of IGF-1. She is now four years post-radiotherapy and has come for follow-up. She has IGF-1 levels of and post-glucose growth hormone levels of 5 ng/mL. She has regular menstrual cycles and has got married. She wants to now plan for pregnancy and wants an opinion, if she can go ahead. She has a cycle with intermenstrual distance of 30 days and her 23rd day’s progesterone levels are 0.1 ng/mL. What should she be advised now?

Should we regularly do MRI in pregnancy?

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waelhammad
2022-11-18
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MRI scan should not be routinely performed in pregnancy unless there is a new or worsening visual compromise. The woman in the present case is subjected to ovulation induction. She conceives, and there is no visual compromise documented during the pregnancy. Postoperatively, she breastfeeds the child but her postdelivery growth hormone levels are high so after breastfeeding is stopped, she is given the option of radiotherapy and somatostatin analog therapy. She opts for somatostatin analog therapy and she is continuing on it and her present GH levels are 2 ng/mL as compared to the pretreatment levels of 8 ng/mL after 6 months of somatostatin analog therapy.

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