Explanation Of Condition

Prolactinomas are the commonest hormone-secreting pituitary adenomas and the only ones likely to be encountered in routine obstetric practice. They arise from the monoclonal proliferation of a lactotroph cell in the anterior pituitary gland. These cells synthesise and secrete prolactin (PRL), the hormone that promotes lactation. Of these adenomas, 90% are microadenomas (<10 mm diameter) and 10% are macroadenomas (>10 mm). Microadenomas may regress spontaneously and do not usually grow significantly, with very few enlarging to become macroadenomas. Macroade-nomas are more likely to expand1.

The clinical features are due to hyperprolactinaemia and the space-occupying effects of the tumour. Hyperprolac-tinaemia causes secondary amenorrhoea and infertility; it inhibits pulsatile GnRH (gonadotropin releasing hormone) release which results in anovulation and low oestrogen levels. Raised PRL levels can also cause galactorrhoea.

Serum prolactin is always raised: in general higher levels are seen with macroprolactinomas. It is important to exclude other causes of hyperprolactinaemia (pregnancy, untreated hypothyroidism, antipsychotic and antiemetic drugs) before imaging the pituitary with MRI.

Pregnancy Guide

Pregnancy Guide

A Beginner's Guide to Healthy Pregnancy. If you suspect, or know, that you are pregnant, we ho pe you have already visited your doctor. Presuming that you have confirmed your suspicions and that this is your first child, or that you wish to take better care of yourself d uring pregnancy than you did during your other pregnancies; you have come to the right place.

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