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[Analysis of treating prolactinoma patients with bromocriptine during pregnancy]
Wei Lian1, Nian Liu, Renzhi Wang
1Department of Neurosurgery, Peking Union Medical College Hospital, CAMS & PUMC, Beijing 100730, China.
Objective:
To explore the therapeutic efficacies and the timing of taking bromocriptine during pregnancy in patients with pituitary prolactinoma.
Methods:
The clinical data were analyzed retrospectively for 230 women with pituitary prolactinoma at our hospital from January 2001 to May 2014. During January 2001 to December 2007, 120 cases were selected as control group. During January 2008 to May 2014, 110 cases were recruited into treatment group.When found pregnant, the control group immediately withdrew while the treatment group continued the original dose of bromocriptine.
Results:
The rate of embryo stopping was 16.7% (20/120) in control group. As compared with the rate of natural population, the difference was statistically significant (P < 0.05); the rate was 0.91% (1/110) in treatment group. As compared with natural population, the difference had no significance (P > 0.05).No significant inter-group difference existed in embryonic malformation rate (P > 0.05).
Conclusion:
Pituitary prolactinoma patients should continue the original dose of bromocriptine for at least 4 months instead of immediate withdrawal during pregnancy. For those with large adenoma, bromocriptine should be taken throughout pregnancy. Blood levels of prolactin, progesterone, human chorionic gonadotropin (HCG) and visual dysfunction should be monitored every 2 weeks. If the levels of progesterone and HCG are low, they should be timely supplemented.If prolactin rises too rapidly and visual dysfunction worsens, the dose of bromocriptine should be appropriately increased. Taking bromocriptine during pregnancy can significantly reduce the rate of embryo stopping without improving the rate of embryo deformity. Thus use of bromocriptine is both safe and necessary.
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