Pregnancy and Labor after Post-traumatic
Panhypopituitarism
Pilka L.1, Šnajderová M.3, Rumpík D.1, Kaplanová T.1, Pilka R.2
1Centrum reprodukční medicíny Zlín, vedoucí prof. MUDr. L. Pilka, DrSc.2Gynekologicko-porodnická klinika LF UP a FN Olomouc, vedoucí prof. MUDr.M. Kudela, CSc. 3Dětská klinika 2. LF UK a FN v Motole, Praha, přednosta prof. MUDr. J. Hořejší, DrSc. |
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Summary:
Objective: We describe a case of 23 years old woman who, with a history of car accident at the age of
11 and severe head injury, attended our Center of Reproductive Medicine complaining of primary
infertility. The accident preceded menarche and the development of inner genitalia (uterus 46 mm,
cervix:corpus ratio 1:1) as well as secondary sexual development was not fully accomplished.
Ovarian failure was accompanied by amenorrhea, if not substituted. Under replacement therapy
regular menstruation was established. Basal hormonal levels was extremely low(FSH and LH0.2-0.3
IU/l, PRL 0.5 ng/ml, estrogens 0.08 nmol/l, PRGE was not detected). With oral administration of
micronized estradiol (Check et al., 2001) endometrial thickness of 9 mm was achieved. All of five
retrieved oocytes were fertilized with partner sperm (normospermy) and three embryos were
transferred. Already the first attempt was successful. Patient suffered with transitional anorexia
and vomiting which could be handled conservatively. Hormonals level were normal. Patient substituted
with Hydrocortison and Euthyrox. On January 2, 2003 the pregnancy was finished by
caesarian section, one week before the delivery term (girl, 2970, Apgar score 10-10-10).
Design: Case report.
Setting: Center of Reproductive Medicine, Zlin.
Conclusion: This care report demonstrates that recent progress in assisted reproduction field
enables to manage successfully even exceptional pathological conditions.
Key words:
post-traumatic panhypopituitarism, oocyte donor, delivery
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