摘要
目的 观察垂体催乳素瘤合并妊娠患者的临床经过,为垂体催乳素瘤患者在孕期的监护及治疗提供依据.方法 选择陕西省妇幼保健院2000年1月至2010年1月确诊为垂体催乳素瘤并且怀孕的患者40例,观察其在孕期药物使用情况、垂体催乳素瘤大小的变化、视力及视野的改变、妊娠结局及胎儿发育情况等.结果 垂体催乳素微腺瘤患者33例,2例发生早产,2例发生自然流产,,其余29例患者均妊娠至足月,其中22例行剖宫产,7例阴道自然分娩,新生儿均存活,且无畸形.7例妊娠晚期MRI检查提示肿瘤增大,3例较前缩小,21例肿瘤大小无明显变化,均无头痛、视力改变及视野缺损等症状发生.垂体催乳素大腺瘤7例,妊娠经过及结局不良,仅有1例妊娠经过顺利,足月妊娠后行剖宫产,新生儿存活,无畸形;2例在妊娠中期出现头痛、视力缺损等症状,给予溴隐亭治疗后症状缓解,继续妊娠至足月,行剖宫产,新生儿存活,无畸形;1例妊娠中期出现上述症状,经溴隐亭治疗后未见明显缓解,引产后行手术＋放射治疗;2例发生早期流产;1例于孕18周流产.结论 垂体催乳素微腺瘤患者孕期停药妊娠结局良好,而大腺瘤患者妊娠经过及结局不良,需引起临床工作者的重视.
Objective To observe the clinical progress of pituitary prolactinoma complicating pregnancy in order to provide some evidence for monitoring and treatment for cases with pituitary prolactinoma in pregnancy. Methods From January 2000 to January 2010 40 pregnant cases diagnosed with pituitary prolactinoma in Shaanxi Maternal and Child Care Service Centre were selected in the study. The drug use during pregnancy, change of tumor size, change of eyesight and visual field, pregnancy outcomes and fetal growth were observed. Results There were 33 cases of microadenoma. Except 2 cases of premature birth and another 2 cases of spontaneous abortion, the other 29 had full-term pregnancy, including 22 undergoing caesarean section and 7 with vaginal spontaneous labor. All of the newborn infants survived without any abnormalities. MRI at late trimester of pregnancy revealed increase in tumor size in 7 cases, decrease in 3 cases and no obvious change in 21 cases. None of the symptoms such as headache, eyesight change or visual impairment occurred in patients. The pregnancy progress and outcomes of 7 cases of macroadenoma were not well. Only one of them underwent cesarean section at full term, and the neonate was survival without abnormality. Headache and visual impairment occurred at second trimester in 2 cases. After treatment with bromocriptine, these symptoms relieved and cesarean section was performed at full term. The neonate was survival without abnormality. Another case, with these symptoms at mid trimester of pregnancy, received operation and radiotherapy after induced abortion when symptoms were not significantly relieved treated with bromocriptine. Early abortion occurred in 2 cases and another one miscarried at 18 gestational weeks. Conclusion The pregnancy outcomes of cases of microadenoma are fine after bromocriptine withdrawl, but the pregnancy progress and outcomes of cases of macroadenoma are not well, which needs attention from clinical physicians.
出处
《中国妇幼健康研究》
2012年第1期120-122,共3页
Chinese Journal of Woman and Child Health Research
关键词
垂体催乳素瘤
溴隐亭
微腺瘤
大腺瘤
妊娠结局
pituitary prolactinoma
bromocriptine
microadenoma
macroadenoma
pregnancy outcomes
