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Prolactinoma in pregnancy.

Mark E Molitch¹

¹Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. molitch@northwestern.edu

Best Practice & Research. Clinical Endocrinology & Metabolism

|November 26, 2011

Summary

This summary is machine-generated.

Dopamine agonists like cabergoline and bromocriptine effectively treat prolactinomas, restoring fertility. Pregnancy outcomes are generally safe, with no increased risks of miscarriage or birth defects, though macroadenoma growth requires monitoring.

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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

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Area of Science:

Endocrinology
Reproductive Medicine
Oncology

Background:

Prolactinomas, pituitary tumors secreting prolactin, frequently cause infertility.
Treatment aims to restore ovulation and fertility, with dopamine agonists being the primary therapeutic approach.

Purpose of the Study:

To review the efficacy and safety of dopamine agonists in treating prolactinomas, particularly concerning fertility restoration and pregnancy outcomes.
To assess the risk of tumor growth during pregnancy and management strategies.

Main Methods:

Review of existing literature on dopamine agonist treatment (cabergoline and bromocriptine) for prolactinomas.
Analysis of pregnancy outcomes, including spontaneous abortions, preterm deliveries, multiple births, and congenital malformations.
Evaluation of tumor growth rates in microadenomas and macroadenomas during pregnancy.

Main Results:

Dopamine agonists restore ovulation and fertility in most patients.
Pregnancy outcomes with cabergoline and bromocriptine show no significant increase in adverse events compared to the general population.
Clinically significant tumor growth occurs in a subset of patients, particularly those with macroadenomas (22.9% without prior treatment).

Conclusions:

Dopamine agonists are safe and effective for managing prolactinomas and achieving pregnancy.
Close monitoring for tumor growth is essential in pregnant patients with macroadenomas.
Management strategies include dopamine agonist re-initiation or, rarely, surgical intervention or delivery.