ABSTRACT

KEY POINTS l Diagnosis: elevated prolactin and MRI-proven pituitary

adenoma. l Preconception: treat with dopamine agonist (bromocrip-

tine or cabergoline) aiming to normalize prolactin and decrease size of adenoma, continuing therapy up to positive pregnancy test. Discourage pregnancy until those aims have been achieved, and any neurologic or visual symptoms or suprasellar involvement have been resolved.

l Maternal risk is adenoma enlargement; this occurs in pregnancy in 1% to 5% of microadenomas and about 15% to 36% of macroadenomas.