Araujo Bárbara, Belo Sandra, Carvalho Davide
Faculty of Medicine, University of Porto. Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal.
Department of Endocrinology, Diabetes and Metabolism Centro Hospitalar S. João. Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal.
Exp Clin Endocrinol Diabetes. 2017 Nov;125(10):642-648. doi: 10.1055/s-0043-112861. Epub 2017 Jul 13.
Management of prolactinomas during pregnancy has always been a challenge. There is a concern about the risk of tumor growth, as well as the effects of the treatment on the developing fetus. Another issue that has been less studied is the outcome of women with prolactinoma after pregnancy and lactation. To evaluate remission of hyperprolactinaemia after pregnancy and lactation in women with prolactinoma. To describe the safety of dopamine agonists for the fetus and pregnancy outcomes. A retrospective study of 32 pregnancies in women with prolactinoma was conducted in a single-centre. Other causes of hyperprolactinemia were excluded. Prolactin level was recorded at the time of diagnosis, during treatment, and during follow-up. The pregnancies resulted in one spontaneous abortion (3.1%) and 31 live births (96.9%). No stillbirths, multiple or ectopic pregnancies or trophoblastic disease were recorded. There was only one malformation (club foot) recorded (3.1%) and normalisation of prolactin after pregnancy without medical treatment occurred in 12% of patients. Fetal exposure to bromocriptine or cabergoline during pregnancy is not associated with an increased risk of adverse neonatal or pregnancy disclosures. There is considerable diversity among endocrinologists in the management of prolactinomas during pregnancy and after birth, which indicates that there is a need for better consensus and for carefully drawn-up guidelines to follow.
妊娠期间泌乳素瘤的管理一直是一项挑战。人们担心肿瘤生长的风险以及治疗对发育中胎儿的影响。另一个研究较少的问题是泌乳素瘤女性在妊娠和哺乳后的结局。评估泌乳素瘤女性妊娠和哺乳后高泌乳素血症的缓解情况。描述多巴胺激动剂对胎儿的安全性及妊娠结局。在单中心对32例患有泌乳素瘤的女性妊娠进行了一项回顾性研究。排除了高泌乳素血症的其他病因。在诊断时、治疗期间及随访期间记录泌乳素水平。这些妊娠导致1例自然流产(3.1%)和31例活产(96.9%)。未记录到死产、多胎或异位妊娠或滋养细胞疾病。仅记录到1例畸形(马蹄内翻足)(3.1%),12%的患者妊娠后泌乳素未经治疗自行恢复正常。胎儿在孕期暴露于溴隐亭或卡麦角林与不良新生儿或妊娠结局风险增加无关。内分泌科医生在妊娠期间及产后泌乳素瘤的管理上存在很大差异,这表明需要更好的共识和精心制定的指南以供遵循。