Prolactinoma in pregnancy

Mark E Molitch*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

70 Scopus citations

Abstract

Prolactinomas commonly cause infertility and treatment usually restores ovulation and fertility. The dopamine agonists are the preferred mode of treatment, with cabergoline generally being preferred to bromocriptine because of its higher therapeutic ratio. Experience with both drugs shows no increase in spontaneous abortions, preterm deliveries, multiple births, or congenital malformations, compared to what is expected in the normal population but the experience with bromocriptine is approximately 10-fold greater than with cabergoline. Clinically significant tumor growth may occur in 2.7% of those with microadenomas, 22.9% in those with macroadenomas without prior ablative treatment and 4.8% of those with macroadenomas with prior ablative treatment. Patients with macroadenomas should have visual fields assessed periodically during gestation. Should symptomatic tumor growth occur, reinstitution of the dopamine agonist is usually successful in shrinking the tumor but delivery if the pregnancy is sufficiently advanced is also an option and transsphenoidal debulking is rarely necessary.

Original languageEnglish (US)
Pages (from-to)885-896
Number of pages12
JournalBest Practice and Research: Clinical Endocrinology and Metabolism
Volume25
Issue number6
DOIs
StatePublished - Jan 1 2011

Keywords

  • adenoma
  • bromocriptine
  • cabergoline
  • hyperprolactinemia
  • infertility
  • macroadenoma
  • malformation
  • microadenoma
  • pregnancy
  • prolactin
  • prolactinoma
  • tumor

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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