Clinical Course and Outcome of Pregnancies in Women with Hyperprolactinemia : Ramathibodi's Experience

Abstract

The clinical course and outcome of pregnancies in women with hyper prolactinemia were determined. There were 18 pregnancies in 15 patients who had been treated with bromocriptine and lisuride. Outcome of pregnancies were 12 full term, 2 induced abortion, 1 spontaneous abortion, 1 ectopic pregnancy, 1 dead fetus in utero and 1 preterm delivery. Tumor complications occured in 3 pregnancies of two patients. One patient with microprolactinoma had severe headache which was rapidly relieved by bromocriptine. The other patient developed severe headache in her first pregnancy and visual field defect in the second pregnancy. She had macroprolactinoma with suprasella extention. The complications were effectively treated with bromocriptine. It is concluded that pregnancy is considerably safe in most hyperprolactinemic patient treated with bromocriptine or lisuride. As soon as pregnancy is diagnosed the medication should be discontinued. Tumor complication during pregnancy is infrequent in women with functional hyperprolactinemia and in women with microprolactinoma. Patient with macroprolactinoma and suprasella extention, however, have a high risk of complication during pregnancy. Thus, tumor size should be reduced either by surgery andlor medi cation before allowing the patient to bec. me pregnant. The rare tumor complication occurring during pregnancy is usually treated effectively by the reinstitution of a prolactin inhibiting agent. (Thai J Obstet Gynaecol 1989;1:115-22.)