Background:
Thyrotropin-secreting pituitary adenomas (TSHomas) during pregnancy are exceedingly rare and pose significant clinical challenges. Managing maternal hyperthyroidism while ensuring optimal fetal development and addressing postpartum recovery, requires a tailored, multidisciplinary approach.

Aim:
To examine maternal symptoms, pregnancy progression, delivery outcomes, neonatal health, and postpartum lactation in women diagnosed with TSHomas during pregnancy.

Methods:
A systematic review was conducted of all reported pregnancies affected by TSHomas between 1993 and 2024. Eleven cases were identified. Extracted data included maternal clinical presentation, management strategies, delivery outcomes, neonatal health, and postpartum course.

Results:
With regard to maternal course, before diagnosis, 82% of women exhibited overt hyperthyroid symptoms, including tachycardia, emotional lability, heat intolerance, and tremors. Galactorrhea, often accompanied by menstrual irregularities, was reported in 36%. During pregnancy, most women required treatment to manage hyperthyroidism. Somatostatin analogs were used in 44% of cases, with close monitoring to mitigate maternal and fetal risks. Two women experienced visual disturbances due to tumor progression. Postpartum, maternal symptoms generally improved with ongoing medical therapy or delayed surgery. No cases of pituitary apoplexy occurred. Regarding neonatal outcomes, ten of the eleven pregnancies resulted in live births; one was electively terminated for non-medical reasons. Seventy three percent (73%) of deliveries occurred at term, while three were preterm (34–36 weeks). No congenital anomalies were observed. One neonate developed transient hypothyroidism. Birth weights ranged between 2500 – 3400 grams. Finally, breastfeeding was successful in 36% of cases. Postpartum use of somatostatin analogs, likely due to their prolactin- suppressing effects, contributed to lactation difficulties. Supportive measures such as lactation consultation were inconsistently reported but remain a critical component of postpartum care.

Conclusion:
With timely diagnosis and coordinated care, pregnancies complicated by TSHomas can result in favorable maternal and neonatal outcomes. Anticipating and managing postpartum lactation challenges is essential for comprehensive care.