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Influence of pregnancies on prolactinomas
Acta Endocrinologica
|July 1, 1982
Summary
This study shows that tailored treatments for hyperprolactinemic patients, using bromocriptine or surgery, successfully led to 65 full-term pregnancies without complications. Prolactin levels varied but generally decreased post-pregnancy, indicating adenomas did not persistently grow.
Area of Science:
- Reproductive Endocrinology
- Neurosurgery
- Oncology
Background:
- Hyperprolactinemia, often caused by pituitary adenomas, can impair fertility.
- Management of hyperprolactinemia in pregnant patients requires careful consideration of tumor size and extension.
Purpose of the Study:
- To evaluate the outcomes of pregnancy in hyperprolactinemic patients managed with differentiated therapeutic strategies.
- To assess the impact of pregnancy on prolactin levels and pituitary adenoma growth.
Main Methods:
- Patients with microprolactinomas without suprasellar extension received bromocriptine.
- Patients with large adenomas or suprasellar extension underwent transsphenoidal surgery, often followed by bromocriptine.
- Pregnancy outcomes and prolactin level dynamics were monitored.
Main Results:
- Sixty-five pregnancies resulted in term deliveries without sella turcica-related complications.
- Prolactin levels showed significant variations during pregnancy, suggesting differential estrogen sensitivity of prolactinoma cells.
- A rapid decline in prolactin levels post-pregnancy in 60 patients indicated no persistent adenoma growth due to estrogen stimulation.
- In 10% of pregnancies, prolactin levels decreased, leading to spontaneous ovulation in 5 patients.
Conclusions:
- Differentiated management of hyperprolactinemic patients is effective for achieving successful pregnancies.
- Estrogen stimulation during pregnancy does not typically cause persistent growth of prolactinomas.
- Spontaneous ovulation may occur during pregnancy in some hyperprolactinemic patients.