Читать книгу Assisted Reproduction Techniques - Группа авторов - Страница 140

The incidence of clinically significant tumor enlargement during pregnancy is < 3% in women with microadenomas (tumors < 1cm in diameter) and approximately 30% in women with macroadenomas (> 1cm in diameter) [1]. Dopamine agonists can therefore be safely stopped in patients with microadenomas as soon as pregnancy has been confirmed, and the patients advised to seek urgent medical attention in the event of severe headaches or visual disturbance [1]. Continuation of dopamine agonist therapy during pregnancy may be considered in cases of macroprolactinoma or where there is evidence of tumor enlargement [1]. If dopamine agonist therapy is discontinued in women with macroprolactinomas, visual‐field testing is recommended in each trimester or more often if necessary. Routine monitoring of PRL levels and MRI should not be performed during pregnancy in patients with prolactinomas, but if visual field defects or progressive headaches develop, a limited MRI without gadolinium can be performed [1].