A 25-year-old woman with a prolactin-secreting pituitary macroadenoma becomes pregnant while on cabergoline. What is the recommended management regarding the dopamine agonist?

• A Continue cabergoline throughout pregnancy as it is FDA category B
• B Switch to bromocriptine and continue throughout pregnancy
• C Discontinue cabergoline as soon as pregnancy is confirmed ✓
• D Continue cabergoline only if tumor enlarges on serial MRI

Explanation

For microprolactinomas and most macroprolactinomas, current Endocrine Society guidance recommends discontinuing the dopamine agonist once pregnancy is confirmed. The risk of clinically significant tumor enlargement during pregnancy is low for microprolactinomas and pre-treated macroprolactinomas. Bromocriptine has more pregnancy safety data but is also typically stopped after confirmation.

Reference: Williams Textbook of Endocrinology, 14th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.