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Hyperprolactinemia
Book chapter

Hyperprolactinemia

Krystel Feghali and Gayatri Jaiswal
Endocrine Diseases in Pregnancy and the Postpartum Period, pp 123-125
2022
DOI: https://doi.org/10.1201/9781003027577-28

Abstract

Formal Visual Field Testing Prolactin Levels RAAS TPO Ab Adrenal Incidentaloma Dopamine Agonists Dopamine Agonist Therapy Lactotroph Cells Prolactin Visual Field Testing Postpartum Thyroiditis Sheehan Syndrome Extrasellar Extension Renin Angiotensin Aldosterone System Pituitary Lactotrophs Hyperprolactinemia Gestational Hypertension Transsphenoidal Surgery Central Diabetes Insipidus Prolactinoma Bitemporal Hemianopsia Thyroid Nodule Polycystic Ovarian Syndrome Pituitary Mri Pregnancy
Prolactinomas are the most common type of hormonally active pituitary tumor. Their highest prevalence is among women in the reproductive age group. Upon achieving pregnancy, dopamine agonists, if previously used, are usually discontinued. Throughout pregnancy, prolactin levels should not be monitored. Visual symptomatology is followed and further evaluated with formal visual field testing. Dopamine agonists are recommended for symptomatic tumor growth and visual field compromise during pregnancy. If indicated, surgical intervention can be performed in the second trimester. Prolactinomas are the most common type of hormonally active pituitary tumor. Visual symptomatology is followed and further evaluated with formal visual field testing. Dopamine agonists are recommended for symptomatic tumor growth and visual field compromise during pregnancy. If indicated, surgical intervention can be performed in the second trimester. Dopamine agonists are recommended as first-line therapy for prolactinoma growth during pregnancy. For adenomas with lack of response with worsening visual symptoms, transsphenoidal surgery can be performed in the second trimester. Prolactinomas are adenomas that arise from lactotroph cells in the pituitary gland which secrete prolactin. Lactotroph cells located in the anterior pituitary secrete prolactin, which serves as an essential mediator of breast milk production and lactation. Macroprolactinomas increase in size in approximately one-third of patients during pregnancy and can be associated with headaches and an increased risk of optic nerve and chiasm compression with visual field symptoms.

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