Holmgren U, Bergstrand G, Hagenfeldt K, Werner S
Acta Endocrinol (Copenh). 1986 Apr;111(4):452-9. doi: 10.1530/acta.0.1110452.
Thirty-five women with prolactinoma have been investigated during 41 pregnancies and 35 lactation periods. Nine of the women had a macroadenoma; 4 of them underwent transsphenoidal microsurgery and one was treated with external pituitary irradiation before pregnancy. All nine were given bromocriptine to induce ovulation. Four women with a microadenoma became pregnant without medical treatment, one shortly after pituitary microsurgery. The other 22 women were treated with bromocriptine only for varying periods before conception. Tumour complications developed in 7 women (20%); 3 had signs of optical nerve compression and 4 showed increased sella volume after pregnancy. All women with tumour complications had been treated with bromocriptine for less than 12 months before conception. Serum prolactin (Prl) was measured every four weeks during pregnancy and after cessation of lactation. In contrast to normal pregnancy, the mean serum Prl did not increase during the second and third trimester of pregnancy in women with pretreatment serum Prl levels above 60 micrograms/l. The lactation period did not have any harmful influence on tumour development. It is concluded that neither pretreatment serum Prl nor radiological changes of the sella turcica can predict tumour development during pregnancy. Treatment with bromocriptine for more than 12 months before conception seems to reduce the risk of tumour progress.
对35例患有泌乳素瘤的女性进行了研究，涵盖41次妊娠和35个哺乳期。其中9名女性患有大腺瘤；4人接受了经蝶窦显微手术，1人在怀孕前接受了垂体外部放疗。所有9人都使用溴隐亭诱导排卵。4名患有微腺瘤的女性未经治疗而怀孕，1人在垂体显微手术后不久怀孕。另外22名女性在受孕前仅接受了不同时期的溴隐亭治疗。7名女性（20%）出现肿瘤并发症；3人有视神经受压体征，4人在怀孕后蝶鞍容积增大。所有出现肿瘤并发症的女性在受孕前接受溴隐亭治疗均少于12个月。在孕期及停止哺乳后每四周测量血清催乳素（Prl）。与正常妊娠不同，孕前血清Prl水平高于60微克/升的女性在妊娠中晚期血清Prl均值未升高。哺乳期对肿瘤发展没有任何有害影响。得出的结论是，孕前血清Prl水平及蝶鞍的放射学改变均不能预测孕期肿瘤的发展。受孕前使用溴隐亭治疗超过12个月似乎可降低肿瘤进展的风险。
