Document Detail

Hypopituitarism and stalk agenesis: a congenital syndrome worsened by breech delivery?
MedLine Citation:
PMID:  1806462     Owner:  NLM     Status:  MEDLINE    
Thirty-seven patients with idiopathic hypopituitarism, of whom 12 had multiple pituitary hormone deficiencies (MPHD) and 25 isolated growth hormone deficiency (IGHD), were evaluated by magnetic resonance imaging (MRI). Twenty-two of the 37 showed congenital anterior pituitary hypoplasia, stalk agenesis and ectopic posterior pituitary gland at the infundibular recess (group A), while the remaining 15 presented isolated anterior pituitary hypoplasia (group B). Perinatal histories obtained from all patients demonstrated that 18/22 children of group A (81.81%) had histories of adverse perinatal events, with breech presentation in 15 (68.18%). Twelve of 12 children of group A born by breech delivery developed MPHD; 3 born by cesarean section for breech presentation had only IGHD. Patients of group B had also a high incidence of perinatal insults (12/15, 80%), but breech delivery was markedly less frequent (13.33 vs. 68.18% of group A) and responsible for only IGHD. Group B had also higher percentages of maternal spontaneous abortion and low birth weight. Our study suggests that several factors may play a role in the development of growth hormone deficiency. Some patients had severe perinatal insults apparently leading to hypopituitarism. We were able to define by MRI a group of patients with congenital abnormalities, such as anterior pituitary hypoplasia, stalk agenesis and posterior pituitary ectopia, among whom breech presentation was very common. In this group, breech delivery was always followed by MPHD while cesarean or normal delivery in such patients was followed by IGHD only.
M Maghnie; D Larizza; F Triulzi; P Sampaolo; G Scotti; F Severi
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hormone research     Volume:  35     ISSN:  0301-0163     ISO Abbreviation:  Horm. Res.     Publication Date:  1991  
Date Detail:
Created Date:  1992-05-14     Completed Date:  1992-05-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0366126     Medline TA:  Horm Res     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  104-8     Citation Subset:  IM    
Pediatric Department, University of Pavia, IRCCS Policlinico S. Matteo, Italy.
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MeSH Terms
Breech Presentation*
Cesarean Section
Growth Disorders / drug therapy,  pathology,  physiopathology*
Growth Hormone / deficiency,  therapeutic use*
Hypopituitarism / pathology,  physiopathology*
Magnetic Resonance Imaging
Pituitary Gland / abnormalities*,  pathology
Pituitary Gland, Anterior / abnormalities
Pituitary Gland, Posterior / abnormalities
Pituitary Hormones, Anterior / blood,  deficiency
Reg. No./Substance:
0/Pituitary Hormones, Anterior; 9002-72-6/Growth Hormone

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