[1]汤绍芳,刘铭.泌乳素瘤患者的围妊娠期管理[J].国际内分泌代谢杂志,2021,41(06):569-572.[doi:10.3760/cma.j.cn121383-20211006-10007]
　Tang Shaofang,Liu Ming..Management of prolactinoma in pregnancy[J].International Journal of Endocrinology and Metabolism,2021,41(06):569-572.[doi:10.3760/cma.j.cn121383-20211006-10007]
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泌乳素瘤患者的围妊娠期管理()
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《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
41
期数:
2021年06期
页码:
569-572
栏目:
专家论坛
出版日期:
2021-12-20

文章信息/Info

Title:
Management of prolactinoma in pregnancy
作者:
汤绍芳; 刘铭
天津医科大学总医院内分泌代谢科 300052
Author(s):
Tang Shaofang;  Liu Ming.
Department of Endocrinology, the General Hospital of Tianjin Medical University, Tianjin 300052, China
关键词:
泌乳素瘤;  妊娠;  多巴胺受体激动剂;  管理
Keywords:
Prolactinoma;  Pregnancy;  Dopamine agonists;  Management
DOI:
10.3760/cma.j.cn121383-20211006-10007
摘要:
泌乳素瘤可以影响生育能力和怀孕结果。泌乳素瘤患者围妊娠期规范化管理包括妊娠前、妊娠中和分娩后,目的是顺利妊娠,使生育和哺乳过程顺利安全,减少泌乳素瘤本身和相关治疗对母亲和胎儿的影响。妊娠前应做好评估,并给予相应的治疗,使患者顺利妊娠。一旦受孕需要从下述3个方面综合考虑,决定最佳管理方案:(1)多巴胺受体激动剂(DAs)对胎儿的影响。(2)妊娠对孕妇泌乳素瘤的影响。(3)产后哺乳对新生儿和产妇的影响。受孕后微腺瘤患者应终止DAs的使用,大腺瘤患者应根据肿瘤大小、妊娠期间的变化和症状决定是否进行药物治疗或手术治疗,甚至终止妊娠。分娩后微腺瘤患者可哺乳,大腺瘤患者不建议哺乳,并密切随访。
Abstract:
Prolactinoma can affect fertility and pregnancy outcomes. Women with a prolactinoma, who are actively seeking pregnancy should consult endocrinologists about their potential fertility and pregnancy outcomes. Careful evaluation and appropriate managements in preconception, gestation, and postpartum are critical for successful conception and optimal pregnancy outcomes. At least three factors should be taken into account in determining management strategies:(1)the effects of the dopamine agonist(DAs)on the developing fetus.(2)the effect of pregnancy on prolactinoma size.(3)the effects of lactation on maternal and neonatal outcomes. Dopamine agonists should be terminated in patients with microadenoma immediately after confirmed pregnancy. Decision regarding whether to continue DAs, surgery, or even termination of the pregnancy, in patients with macroadenoma should be individualized, based on the size of the adenoma and symptoms. Breastfeeding is feasible in patients with microadenomas after delivery, but is not recommended for patients with macroadenoma.

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备注/Memo

备注/Memo:
通信作者:刘铭, Email:mingliu@tmu.edu.cn
更新日期/Last Update: 2021-12-10