Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Best Pract Res Clin Endocrinol Metab. 2011 Dec;25(6):885-96. doi: 10.1016/j.beem.2011.05.011.
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.
催乳素瘤通常会导致不孕，治疗通常可以恢复排卵和生育能力。多巴胺激动剂是首选的治疗方法，卡麦角林通常比溴隐亭更受欢迎，因为它的治疗效果更好。与正常人群相比，这两种药物的使用经验并没有增加自然流产、早产、多胎或先天性畸形的风险，但溴隐亭的使用经验大约是卡麦角林的 10 倍。在微腺瘤患者中，有 2.7%可能会出现临床显著的肿瘤生长，在未经消融治疗的大腺瘤患者中，有 22.9%会出现这种情况，在有过消融治疗的大腺瘤患者中，有 4.8%会出现这种情况。患有大腺瘤的患者应在怀孕期间定期评估视野。如果出现有症状的肿瘤生长，重新使用多巴胺激动剂通常可以成功缩小肿瘤，但如果妊娠已经足够成熟，也可以选择分娩，而且很少需要经蝶窦切除术来进行肿瘤切除术。
