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DOI: 10.1055/s-0045-1809442
Management of Prolactinoma during Pregnancy by Physicians from the Middle East and North Africa: A Case-Based Survey
Autoren
Funding None.
Abstract
Introduction
The guidelines for managing prolactinomas during pregnancy are primarily based on retrospective evidence or expert opinion.
Methods
A case-based questionnaire was sent to a convenience sample of endocrinologists (N = 116) and internists (N = 13) in the Middle East (N = 147) and North Africa (N = 33). Three cases of varying severity were presented, ranging from microprolactinoma to large macroprolactinoma compressing the optic chiasm.
Results
In the case of microprolactinoma, 86.7% of respondents would discontinue dopamine agonist (DA) medications when pregnancy is confirmed, 66.1% would discontinue serum prolactin measurement during pregnancy, and 95.4% would not request pituitary imaging routinely if no new symptoms developed. In contrast, only 20.0% would perform regular formal visual field (VF) testing throughout pregnancy. In the case of macroprolactinoma with no VF defect, 38.9% chose to discontinue DA therapy upon confirmation of pregnancy, 20.0% would either perform regular magnetic resonance imaging (MRI) during pregnancy or if serum prolactin were thought to be elevated out of proportion by clinical judgment, and 36.7% would not perform regular formal VF monitoring during pregnancy. In the management of macroprolactinoma with VF defect, 61.1% elected to continue DA therapy, whereas 33.9% considered referral for surgical excision as the treatment of choice. Note that 42.8% would perform regular MRIs during pregnancy, and 90.0% would perform regular formal VF monitoring.
Conclusion
A survey of physicians revealed a diversity in managing prolactinomas during pregnancy, better education and regional adoption of the guidelines.
Keywords
survey - professional practices - prolactinoma - prolactin - dopamine agonists - pregnancy outcomeAuthors' Contributions
S.A.B. and M.H.A. conceived the study's idea. S.A.B. adapted the questionnaire, managed the online survey, and drafted the manuscript. All other authors reviewed the data, revised the manuscript, and approved its final version.
Compliance with Ethical Principles
Although participation in the study poses no risk at all to participants, however, the Institution Review Board of Sheikh Khalifa Medical City, Abu Dhabi, approved the study [Reference Number: REC-13.08.2017 [RS-502]. Respondents provided digital informed consent before answering the survey questions, and all data were analyzed anonymously.
Publikationsverlauf
Artikel online veröffentlicht:
10. Juni 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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