Successful pregnancy in an acromegalic patient during 2-Br-alpha-ergocryptine (CB-154) therapy

Foeto-placental function and hormone levels in the maternal, foetal and amniotic compartments have been investigated in an acromegalic woman who was treated with 20 mg bromocriptine/day throughout gestation. Bromocriptine therapy during pregnancy had no effect on urinary oestriol excretion and plasma levels of unconjugated oestriol, progesterone, human placental lactogen, cystine aminopeptidase and heat-stable alkaline phosphatase. The maternal and foetal (cord )blood and amniotic fluid showed prolactin levels of 3.8, 6.5 and 1700 ng/ml, respectively, in the 39th week of pregnancy during bromocriptine therapy. Compared with data from normal pregnancies, these values demonstrated that bromocriptine or an active metabolite crossed the term placenta to suppress prolactin secretion from the foetal pituitary gland and that the prolactin level in amniotic fluid was scarcely affected by the drug. Maternal, foetal and amniotic fluid growth hormone levels were 27.0, 33.0 and 3.8 ng/ml, respectively, thus indicating that dopamine agonists suppress growth hormone only in acromegalic patients, and not in normal babies. Bromocriptine had no effect on thyroid-stimulating hormone concentrations in maternal, foetal and amniotic compartments.