TABLE 2.

Summary of the published cases of transsphenoidal surgery performed during pregnancy for the management of Cushing's disease

Reference (Year)	Time of TSS (trimester, week of gestation)	Surgical complications	Maternal and foetal complications	Delivery	Reported outcome of Cushing's disease
Casson et al. 65 (1987)	Second, 22 weeks	NR	Pre‐eclampsia at 28 weeks Foetal intubation and pneumothoraces	Emergency caesarean at 30 weeks	NK
Coyne et al. 66 (1992)	Second, 14 weeks	Permanent DI	Nil	NK	Remission
Pinette et al. 61 (1994)	Second, 16 weeks	NR	Intrauterine death	33 weeks, tight nuchal cord	Persistence of disease
Ross et al. 67 (1995)	Second, 18 weeks	CSF leak, transient DI	Labile HTN (32 weeks) IUGR, foetal distress (37 weeks)	Induction of labour, emergency caesarean (37 weeks)	Remission
Mellor et al. 68 (1998)	Second a	NR	Severe eclampsia (33 weeks) Low birth weight (2.3 kg)	Emergency caesarean under general anaesthesia (33 weeks)	Remission
Verdugo et al. 69 (2004)	Second, 23 weeks	NR	Nil	39 weeks, vaginal delivery	Remission
Lindsay et al. 6 (2005)
Case 1	Second, 18 weeks	NR	Severe pre‐eclampsia IUGR, low birth weight (1.7 kg)	Induced vaginal labour, 34 weeks	Remission
Case 2	Second, 14 weeks	Transient SIADH	Intrauterine death	Stillborn delivered at 33 weeks, tight nuchal cord	Persistence of disease BAH and RT required 3 months post pregnancy
Case 3	First, 10 weeks +5 days	NR	NR	Vaginal delivery at term	Remission
Case 4	Second, 17 weeks	Transient SIADH	Persistent HTN, pre‐eclampsia Reversal of cord blood flow, foetal death 5 days after delivery	caesarean (at 24 weeks)	Remission
Boronat et al. 70 (2010)	Second, 16 weeks	NR	Persistent HTN, gestational diabetes (24 weeks) Low birth weight (2.4 kg)	Induction of labour at 34 weeks	Persistence of disease, also had ketoconazole during first trimester and metyrapone for remainder of pregnancy
Abbassy et al. 71 (2015)	Second, 18 weeks	Permanent DI	NR	Vaginal, 39 weeks	Remission
Jolly et al. 10 (2019)	Second, 23 weeks	nil	HTN (33 weeks) Congenital diaphragmatic hernia, foetal death	Emergency caesarean section at 38 weeks	Remission
Sridharan et al. 4 (2021)	Second, 20 weeks	nil	Vomiting and hypoglycaemia post‐operatively (before administration of hydrocortisone)	Vaginal delivery at 40 weeks	Remission

^a Week of second trimester not specified.

Abbreviations: BAH, bilateral adrenal hyperplasia; CSF, cerebrospinal fluid; DI, diabetes insipidus; HTN, hypertension; IUGR, intrauterine growth restriction; NK, not known; NR, not reported; RT, radiotherapy; SIADH, syndrome of inappropriate antidiuretic hormone secretion; TSS, transsphenoidal surgery.