Critical Care Obstetrics and Gynecology

Prolactinoma and Gestation: A Reality

2018 Naliato ECO, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

We report our experience with 11 pregnancies in 10 patients with microprolactinoma treated at the Endocrine Unit of a University Hospital in Rio de Janeiro, Brazil, through a period of 9 years. Age at diagnosis of prolactinoma and pregnancy confirmation, time elapsed between this diagnosis and pregnancy, prolactin levels at the diagnosis of prolactinoma and detection of pregnancy, pre-gestational use of dopamine agonists, and the occurrence of complications during pregnancy, birth and lactation were evaluated. With respect to the post-partum period, the levels of prolactin and the evolution of the tumor size are presented.

Ages at diagnosis of prolactinoma ranged from 13 to 34 years (mean=25.4 years), and by the time of the detection of pregnancy, 23 to 36 years (mean=31.2 years). The time elapsed between the diagnosis of prolactinoma and the detection of pregnancy ranged from 2 to 10 years (mean=5.8 years), and the pre-gestational prolactin values, from 17.1 to 63.3 ng/mL (mean=31.6 ng/mL). The average tumor size was 0.55 cm.

Regarding the pre-gestational treatment, 60% of the women used Cabergoline (CB) and 40% women used Bromocriptine (BC). Upon learning of the gestation, all of them stopped the medication, and thus they stayed throughout the entire pregnancy. There were no complications involving the conceptuses and only one patient did not breastfeed. All required a return to Dopaminergic Agonists (AD) use after gestation. The 10 patients responded to the reinsertion of AD with normalization of prolactin levels. We conclude that patients with prolactinoma can safely become pregnant with medical care.

Author(s):

Erika CO Naliato, Gabriel Neiva Mello Vanni, Rafaela Palhano Sifuentes Melo and Alice Helena Dutra Violante

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