[Pregnancy and hyperprolactinemia. Review of therapeutic measures apropos of a series of 35 patients].

Forty-eight pregnancies were observed in 35 patients with hyperprolactinaemia divided into 3 groups according to their initial radiological appearances: normal sella turcica (Group I, n = 11), microadenoma (Group II, n = 12) or macroadenoma without suprasellar expansion, visual defect or pituitary deficiency (Group III, n = 12). Twenty-seven patients were treated with Bromocriptine (Br) from the outs six by adenomectomy + Br, one by adenomectomy alone complicated by meningitis and by corticotropic and thyrotropic hormone deficiencies, followed by amenorrhea despite normalisation of the hyperprolactinaemia requiring induction of a first pregnancy with Clomid. As regards the pregnancies induced by Br (43/48), Br was withdrawn at an early stage in Group I and in the majority of cases in Groups II and III. In all, 37 pregnancies came to term; after Br therapy we observed 5 spontaneous abortions and 3 premature deliveries; 2 caesarian sections were performed before term (one case of hypertension and one adenomatous expansion); one early termination was performed for a tumoral complication. One congenital abnormality (oesophageal atresis) was detected. These observations support the results of extensive studies showing no effects of Br on the outcome of pregnancy and no detectable teratogenic effects with this drug. Five pituitary complications occurred during pregnancy after withdrawal of Br; 1 case of headaches with expansion of a macroadenoma cured by adenometry after prophylactic caesarian section before term; 1 case of optic chiasma compression (Group III) which responded to emergency surgery and 2 cases of pituitary apoplexy (Groups II and III) which responded favourably to Br and in which pregnancy continued normally.(ABSTRACT TRUNCATED AT 250 WORDS)