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The long-term effects of pregnancy and bromocriptine treatment on prolactinomas--the value of radiologic studies
S Z Badawy1, J C Marziale, A E Rosenbaum
1Department of Obstetrics and Gynecology, State University of New York Health Science Center at Syracuse 13210, USA.
Objective:
To evaluate the long-term effects of pregnancy and bromocriptine treatment on prolactin-secreting pituitary tumors in women undergoing infertility treatment for prolactinomas.
Methods:
The records of 17 patients with prolactinomas were reviewed. Data regarding age, prepregnancy baseline and postpartum serum prolactin levels, and radiologic studies including CT or MRI were assessed. 16 patients were treated with bromocriptine before achieving pregnancy. Bromocriptine therapy was resumed after delivery for the duration of 1 to 14 years.
Results:
45% of pregnancies did not affect the size of prolactinomas, 27% of pregnancies showed a decrease in size of prolactinomas or radiologic evidence of resolution of the tumor and 27% of pregnancies demonstrated radiologic increase in the size of prolactinomas.
Conclusions:
It is safe for patients with prolactinomas to achieve pregnancy following bromocriptine treatment. Pregnancy may lead to a slight decrease in the size of prolactinomas, increase in size, no change, and in some cases, complete resolution. There were no visual field changes during the pregnancies. Pregnancy and long-term bromocriptine treatment may be helpful in reduction of the size of the tumor.
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