Hyperprolactinemia
ICD-10 E22.1 · ICD-11 5A60.1

Symptomatic Pituitary Prolactinoma Growth During Pregnancy — When Dopamine Agonist Therapy Has Failed

This protocol covers a specific and challenging situation: a pregnant patient whose pituitary prolactinoma continues to grow symptomatically despite dopamine agonist treatment, requiring escalation to the next management step.

Pregnancy complicated by symptomatic growth of a pituitary prolactinoma — a condition in which ongoing tumour expansion causes symptoms that first-line medical therapy has not adequately controlled.

Bromocriptine (the dopamine agonist of choice) was used, with cabergoline as an alternative for patients who could not tolerate bromocriptine. The treatment goal was a decrease in tumour size and improvement of symptoms. When these targets are not reached, escalation to the next step is warranted.

When dopamine agonist therapy does not achieve adequate tumour reduction and symptom relief, a surgical approach targeting the adenoma may be indicated. The complete protocol specifies the decision criteria and the recommended course of action.

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References

DOI: 10.1210/jc.2010-1692 View source ↗