This protocol addresses a specific and clinically important scenario: a patient with hyperprolactinemia who develops symptomatic growth of a pituitary prolactinoma during pregnancy.

Clinical Scenario

The patient is pregnant and has experienced symptomatic growth of a pituitary prolactinoma during the course of pregnancy. This combination defines the specific population for this protocol.

Treatment Approach

Dopamine agonist therapy is the primary intervention for this scenario. The preferred agent, the circumstances under which an alternative agent is used, and all further management details are available in the full protocol.

Treatment Goals

The primary clinical objectives are decrease in tumor size and improvement of symptoms.

References

DOI: 10.1210/jc.2010-1692

We recommend bromocriptine therapy in patients who experience symptomatic growth of a prolactinoma during pregnancy.
Bromocriptine in divided doses is the recommended dopamine agonist of choice because of the larger published experience.
In patients who cannot tolerate bromocriptine, cabergoline may be administered.
If reinitiation of dopamine agonist therapy does not decrease tumor size and lead to improved symptoms, surgical resection may be indicated.

View source ↗

Treatment of Hyperprolactinemia in Pregnancy with Symptomatic Growth of a Pituitary Prolactinoma

References