Prolactin-producing microadenomas in pregnancy

Fifty-four patients with evidence of a prolactin-producing pituitary microadenoma were followed through pregnancy. Obstetric complications included four spontaneous abortions, one stillbirth, and one premature delivery. Four patients developed visual defects (two with abnormal visual fields). Four patients noted headaches. The progressive rise in maternal prolactin levels seen in a control group was not seen in the prolactinoma patients. In the tumor patients, maternal prolactin levels were already elevated early in pregnancy and did not increase further. Maternal prolactin levels were not predictive of any complications. The present study suggests that pregnancy is safe in microadenoma patients and that the few complications encountered are highly amenable to appropriate management.