Luisa Ruas

Giant macroprolactinoma and pregnancy

Prolactinomas are a common cause of gonadal dysfunction and infertility. We present the case of a 38-year-old woman with history of amenorrhea and infertility. At seven weeks of pregnancy she presented neuro-ophthalmologic complaints of headaches, diplopia, and right ptosis. The work-up study revealed an invasive pituitary macroadenoma with a maximum diameter of 9 cm and serum prolactin of 25,800 ng/mL (3-20). At 12 weeks, she was referred to the Endocrinology Department of the Coimbra University Hospital and started therapy with bromocriptine, initially 5 mg/day and then at crescent doses. Hyperprolactinemia was rapidly and drastically reduced to 254 ng/mL three weeks after taking bromocriptine 15 mg/day. Tumoral volume was reduced and there was improvement of III pair paresis. At 38 weeks, a male healthy baby was born. This is a relevant clinical case that illustrates the efficacy and safety of bromocriptine therapy during pregnancy, even in severe cases like this one.

CO007. DIABETES TIPO 1 E GRAVIDEZ: MÚLTIPLAS ADMINISTRAÇÕES DE INSULINA VERSUS BOMBA PERFUSORA DE INSULINA

2011 (p = 0,136). Em 2010 obteve-se resultado normal na prova de reclassificacao em 84,4%, comparativamente a 75,6% em 2011 (p = 0,347). Conclusao: O numero de gravidas com DG aumentou em 53% de 2010 para 2011. Em 2011 o diagnostico de DG, bem como a 1a consulta foram realizados mais precocemente. A maioria dos diagnosticos ocorreu as 24-28 semanas mas um numero consideravel foi efectuado no 1o trimestre. Aumentou a percentagem de gravidas sob insulinoterapia e obteve-se menor proporcao de RN com macrossomia e GIG. A percentagem de RN com morbilidade, bem como o resultado da prova de reclassif icacao nao foram estatisticamente diferentes entre 2010 e 2011. Apos a implementacao dos novos criterios observou-se um diagnostico mais precoce e um tratamento mais agressivo da DG, o que pode ter contribuido para a reducao de algumas complicacoes do RN.