妊娠合并垂体泌乳素腺瘤的处理和分析

Management of prolactinomas during pregnancy

目的 探讨垂体泌乳素腺瘤患者妊娠的安全性以及孕前和孕期处理垂体泌乳素腺瘤对妊娠结局的影响。方法 回顾性分析 1986～ 2 0 0 0年间收治的 32例垂体泌乳素腺瘤患者的孕前、孕期及分娩情况。其中 ,垂体泌乳素微腺瘤 2 2例 ,垂体泌乳素大腺瘤 10例。结果 孕期垂体泌乳素腺瘤体积增大出现压迫症状者 6例 (19% ) ,其中垂体泌乳素微腺瘤 1例 ,垂体泌乳素大腺瘤 5例 ;此 6例患者孕期均接受溴隐亭治疗 ,其中 2例垂体泌乳素大腺瘤患者孕期切除了肿瘤。妊娠合并垂体泌乳素腺瘤患者妊娠并发症为妊娠高血压综合征 4例 ,妊娠期糖尿病 1例 ,胎儿生长受限 3例 ,羊水过少 1例 ,轻度妊娠水肿 1例。分娩方式为剖宫产 17例 (5 3% ) ,其中垂体泌乳素大腺瘤 10例均行剖宫产术。新生儿未发现异常。结论 垂体泌乳素微腺瘤孕期停药安全 ;垂体泌乳素大腺瘤孕期发生体积增大者危险性高。垂体泌乳素腺瘤不增加妊娠并发症 。

Objective To evaluate the safety of discontinuing drugs for prolactinoma during pregnancy, and the effect of prolactinoma on pregnancy Methods Thirty two cases of prolactinoma in pregnancy were enrolled, 22 microadenoma and 10 macroadenoma Results Adenoma growing appeared in 6 cases Among them 5 were macroadenoma, dopamine agonists were then reused and surgery were carried out in 2 of them The other was one microadenoma, dopamine agonists was reinstituted No side effect on fetus′s weight and appearance was seen Gestation complication was as nomal Conclusions Discontinuing dopamine agonists is safe during pregnancy for microadenoma The risk of macroadenoma enlargement during pregancy is high Rregular visal field testing is necessary during pregnancy Prolactinoma doesn′t influence gestation complication and fetus