Pregnancy and hyperprolactinemia

Abstract

After endocrinological and radiological evaluation of a hyperprolactinemia 13 patients became pregnant under bromocriptine therapy. In two of these patients a selective adenomectomy was performed by the transphenoidal route because of a prolactin (PRL) secreting adenoma. In 12 patients the pregnancy was not complicated. The serum PRL levels were different but mostly in a normal range. The control of x-ray and visual field in patients with a rapid increase of the PRL levels did not result in a tumor recurrence. After a normal course of the serum PRL concentrations one patient with a microadenoma developed suddenly a chiasma syndrome in the 31th week of gestation. The further evaluation resulted in a pituitary tumor with suprasellar extension. The discrepancy between the radiological result and the normal serum PRL levels was explained by a hemorrhage into the adenoma. After the operation the chiasma syndrome was reversible within a short period. Altogether, the course of the pregnancies was not complicated. We did not see fetal malformations. Post partum the sella x-ray of all patients did not reveal any significant changes so far.