Prolaktinom

[Tira]

Sehr geehrter Herr Professor Wust,

Kann ein Prolaktinom durch eine Geburt ausgelöst werden ?

[Prof. Wust]

RE: Prolaktinom


Prolactinome können während der SS Probleme aufwerfen und zu Kinderlosigkeit führen (s. die unten kopierte Zusammenfassung). Es ist aber nie beschrieben worden, dass umgekehrt eine SS ein Prolactinom auslöst. Ich kann auch nicht die Kausalkette erkennen. Da Frauen im gebärfähigen Alter am häufigsten Prolactinome entwickeln, sind hier von Zeit zu Zeit möglicherweise zufällige Korrelationen zu beobachten.

Management of prolactinomas during pregnancy.
AU: Molitch,-M-E
AD: Center for Endocrinology, Metabolism and Molecular Medicine, Northwestern University Medical School, Chicago, IL 60611, USA.
SO: J-Reprod-Med. 1999 Dec; 44(12 Suppl): 1121-6
AB: Infertility is a common problem for women presenting with hyperprolactinemia, and lowe-ring of prolactin (PRL) levels to normal or near normal is often necessary to permit ovulation. Dopamine agonists are effective in a majority of women, with cabergoline somewhat more effective than bromocriptine. Bromocriptine use by the mother appears to be safe for the de-veloping fetus when its use is discontinued four to six weeks after conception. For women with microadenomas, the subsequent risk of adenoma growth during pregnancy appears to be 1% after discontinuing the drug, and symptomatic follow-up each trimester appears to be reasonable in such patients. For women with macroadenomas, bromocriptine may be dis-continued after diagnosis of pregnancy (23% risk of tumor enlargement) or continued throug-hout pregnancy with monthly visual field testing. Alternatively, prepregnancy debulking of the tumor may be undertaken with appropriate follow-up (2.8% risk of tumor enlargement). Although data are less extensive on cabergoline, preliminary evidence does not suggest any increase in adverse fetal outcomes. As such, therapeutic abortion is not warranted if pregnancy occurs during cabergoline treatment. The drug appears reasonably safe for conti-nued use. Further accrual of safety data will clarify that issue.