Growth of a Prolactinoma During Pregnancy

Dommerholt, H. B. R.; Assies, Johanna; Werf, A.J.M. van der

doi:10.1111/j.1471-0528.1981.tb00939.x

Cited by 9 publications

(2 citation statements)

References 41 publications

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“…We included 51 studies on medical treatment of prolactinomas during pregnancy (28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78), and another 26 studies on medical treatment of hyperprolactinaemia (including patients with prolactinomas in mixed populations)…”

Section: Clinical Question I: What Is the Safety Profile And Teratogenicity Of Medical Treatment During Pregnancy In Patients With Prolacmentioning

confidence: 99%

ESE Clinical Practice Guideline on functioning and nonfunctioning pituitary adenomas in pregnancy

Luger

Broersen

Biermasz

et al. 2021

European Journal of Endocrinology

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Pregnancies are rare in women with pituitary adenomas, which may relate to hormone excess from secretory subtypes such as prolactinomas or corticotroph adenomas. Decreased fertility may also result from pituitary hormone deficiencies due to compression of the gland by large tumours and/or surgical or radiation treatment of the lesion. Counselling premenopausal women with pituitary adenomas about their chance of conceiving spontaneously or with assisted reproductive technology, and the optimal pre-conception treatment, should start at the time of initial diagnosis. The normal physiological changes during pregnancy need to be considered when interpreting endocrine tests in women with pituitary adenomas. Dose adjustments in hormone substitution therapies may be needed across the trimesters. When medical therapy is used for pituitary hormone excess, consideration should be given to the known efficacy and safety data specific to pregnant women for each therapeutic option. In healthy women, pituitary gland size increases during pregnancy. Since some pituitary adenomas also enlarge during pregnancy, there is a risk of visual impairment, especially in women with macroadenomas or tumours near the optic chiasm. Pituitary apoplexy represents a rare acute complication of adenomas requiring surveillance, with surgical intervention needed in some cases. This guideline describes the choice and timing of diagnostic tests and treatments from the pre-conception stage until after delivery, taking into account adenoma size, location and endocrine activity. In most cases, pregnant women with pituitary adenomas should be managed by a multidisciplinary team in a centre specialised in the treatment of such tumours.

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Section: Clinical Question I: What Is the Safety Profile And Teratogenicity Of Medical Treatment During Pregnancy In Patients With Prolacmentioning

confidence: 99%

ESE Clinical Practice Guideline on functioning and nonfunctioning pituitary adenomas in pregnancy

Luger

Broersen

Biermasz

et al. 2021

European Journal of Endocrinology

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“…It is now well established that treatment with bromocriptine lowers prolactin levels and restores fertility [2][3][4], Once the patient has conceived, the physician must decide whether to withhold treatment during the pregnancy. Continuous bromocriptine ad ministration suppresses prolactin levels [5], and so far has not been associated with any significant clinical or biochemical fetal anomalies, but the total number of patients reported who have been treated throughout pregnancy is small [5,6], On the other hand, withdrawal of treatment usually results in a return to the hyperprolactinemic state [7], and there is a small but well documented risk of rapid tumor enlargement and optic nerve compression [4,8]. The factors that deter mine the onset of tumor expansion during pregnancy have not yet been identified [8], -182 9 30 7 0 0 ---0 49 10 24 4 1 1 --+ -79 11 24 10 9 10 --+ -637 12 25 6 6 6 --+ -1,112 13 26 3 1 3 + -+ + 3.120 14 23 6 6 6 + -+ -390 Mean 29 6 4 5 761 1 Secondary infertility; 0 = not done.…”

Section: Introductionmentioning

confidence: 99%

Prolactin Levels in Pregnancy: Comparison of Normal Subjects with Patients Having Micro- or Macroadenomas after Early Bromocriptine Withdrawal

Woodhouse¹,

Niles²,

McDonald

et al. 1985

Horm Res

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14 previously infertile patients, 11 with radiologically abnormal fossae, and a mean prolactin level of 761 ng/ml (range 49-4,500 ng/ml) conceived on 19 occasions during bromocriptine treatment. So far, 15 healthy infants have been delivered. Treatment was withdrawn soon after conception and the subsequent prolactin changes compared with those of 44 normal subjects. Prolactin levels returned to pretreatment values in 7, but stayed within our normal range (less than 350 ng/ml) in the 6 remaining patients studied. No patient developed signs or symptoms of tumor enlargement. 2 patients, 1 of them with the largest tumor, have now normal prolactin levels and can be considered as cured. Bromocriptine treatment can restore fertility and be safely withdrawn during pregnancy even in patients presenting with large tumors. Nevertheless, patients should be carefully monitored and treatment with bromocriptine re-introduced if necessary.

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Diseases of the Pituitary and Adrenal Gland

Swiet¹

2002

Medical Disorders in Obstetric Practice

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Growth of a Prolactinoma During Pregnancy

Cited by 9 publications

References 41 publications

ESE Clinical Practice Guideline on functioning and nonfunctioning pituitary adenomas in pregnancy

ESE Clinical Practice Guideline on functioning and nonfunctioning pituitary adenomas in pregnancy

Prolactin Levels in Pregnancy: Comparison of Normal Subjects with Patients Having Micro- or Macroadenomas after Early Bromocriptine Withdrawal

Diseases of the Pituitary and Adrenal Gland

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