ergoline and Puerperal-Disorders

1) Evaluate the capacity of cabergoline to inhibit lactogenesis by the administration of a single dose of 1 mg within 24 h of birth, primary inhibition. 2) Evaluate the capacity of cabergoline to suppress lactopoiesis (lactation) by the administration of 0.25 mg twice a day for 2 days, secondary inhibition. 3) Evaluate the collateral effects of cabergoline at these two doses. 4) Evaluate the reduction rate of prolactin (PRL) at 4 and 14 days after cabergoline administration.. A prospective study was performed from 1/2/1995 to 31/1/1996 in 100 puerperae with indications for lactation with follow-up at 4 and 14 days after drug administration. The study was performed in the Division of Gynecology and Obstetrics of Sanremo Hospital in collaboration with the Analysis Service.. Cabergoline inhibited primary and secondary lactation in all the puerperae examined. In 92% of cases lactation was suppressed following a single dose whereas a second treatment cycle was required in 8%. Twenty-two cases reported slight collateral effects without the need to resort to additional treatment. In 4 cases the collateral effects were of moderate intensity and it was necessary to administer symptomatic treatment. Mean levels of serum PRL at 4 and 14 days after cabergoline administration were respectively 12.5 and 18.2 ng/ml.. Cabergoline, a new dopaminergic drug with long-term inhibition of PRL production and secretion, can inhibit lactogenesis and lactopoies in 92% of cases at a dose of 1 mg; it can reduce long-term PRL levels (18.2 ng/ml) and in 4% it is necessary to resort to symptomatic treatment of the undesirable effects caused.

Topics: Cabergoline; Dopamine Agonists; Ergolines; Female; Humans; Infant, Newborn; Lactation; Pregnancy; Prolactin; Puerperal Disorders

Pathophysiological mechanisms of peripartum cardiomyopathy are not yet completely defined, although there is a strong association with various factors that are already known, including pre-eclampsia. Peripartum cardiomyopathy treatment follows the same recommendations as heart failure with systolic dysfunction. Clinical and experimental studies suggest that products of prolactin degradation can induce this cardiomyopathy. The pharmacological suppression of prolactin production by D2 dopamine receptor agonists bromocriptine and cabergoline has demonstrated satisfactory results in the therapeutic response to the treatment. Here we present a case of an adolescent patient in her first gestation with peripartum cardiomyopathy that evolved to the normalized left ventricular function after cabergoline administration, which was used as an adjuvant in cardiac dysfunction treatment. Subsequently, despite a short interval between pregnancies, the patient exhibited satisfactory progress throughout the entire gestation or puerperium in a new pregnancy without any cardiac alterations. Dopamine agonists that are orally used and are affordable in most tertiary centers, particularly in developing countries, should be considered when treating peripartum cardiomyopathy cases.

Topics: Adolescent; Cabergoline; Cardiomyopathies; Dopamine Agonists; Ergolines; Female; Humans; Pregnancy; Pregnancy Complications, Cardiovascular; Pregnancy Outcome; Puerperal Disorders

Topics: Adult; Antipsychotic Agents; Cabergoline; Cesarean Section; Dopamine Agonists; Ergolines; Female; Hallucinations; Humans; Lactation; Postoperative Complications; Pregnancy; Pregnancy Complications; Pregnancy, Twin; Psychomotor Agitation; Psychotic Disorders; Puerperal Disorders; Risperidone; Sleep Initiation and Maintenance Disorders

The current survey study investigated the recurrence rate of hyperprolactinemia after cabergoline (CAB)-induced pregnancy and after lactation as well as safety of CAB exposure during early gestation.. From 1997-2008, 143 pregnancies were recorded in 91 patients with hyperprolactinemia (age 30.4 ± 4.7 yr, 76 microadenomas, 10 macroadenomas, and five nontumoral hyperprolactinemia). CAB therapy was discontinued within wk 6 of gestation in all. Pregnancies were monitored until delivery or termination, during and after lactation, twice yearly up to 60 months. The incidence of abortions, premature delivery, and fetal malformations was also analyzed.. Pregnancies resulted in 13 (9.1%) spontaneous abortions and 126 (88.1%) live births. No neonatal malformations and/or abnormalities were recorded. In 29 of 91 patients (three with macroadenomas), treatment with CAB had to be restarted within 6 months after lactation because of hyperprolactinemia recurrence, whereas in 68% of cases, no additional therapy was required up to 60 months. No tumor mass enlargement was observed. All patients but three were breastfeeding, 35 (38.5%) for less than 2 months and 56 (61.5%) for 2-6 months. Three months after cessation of lactation and 60 months after pregnancy, no difference in prolactin levels was found between patients nursing for less than 2 months and 2-6 months.. Fetal exposure to CAB at conception does not induce any increased risk of miscarriage or malformations. Pregnancy is associated with normalization of prolactin levels in 68% of patients. Breastfeeding does not increase the recurrence rate of hyperprolactinemia.

Topics: Adult; Antineoplastic Agents; Breast Feeding; Cabergoline; Data Collection; Dopamine Agonists; Ergolines; Female; Humans; Hyperprolactinemia; Infertility, Female; Lactation; Observation; Pituitary Neoplasms; Pregnancy; Pregnancy Complications, Neoplastic; Pregnancy Outcome; Prolactinoma; Puerperal Disorders; Recurrence; Time Factors

The aetiology of peripartum cardiomyopathy (PPCM) is still largely unknown. Recent evidence suggests that the breakdown products from prolactin can induce cardiomyopathy. Prolactin secretion can be reduced with bromocriptine which had beneficial effects in a small study. We present a case of a patient with PPCM who received cabergoline, a strong and long lasting antagonist of prolactin secretion. Following treatment, her prolactin levels dropped swiftly. N-terminal pro-BNP levels, which had remained high up to that point, dropped within 1 day (7006 to 4408 pg/mL). Echocardiographic left ventricular ejection fraction recovered from 26% on day 4 postpartum to 32% and later 47% on days 2 and 5 after cabergoline treatment. To our knowledge, this is the first description of a case of PPCM in which cabergoline was administered.

Topics: Adult; Cabergoline; Cardiomyopathies; Echocardiography; Ergolines; Female; Humans; Natriuretic Peptide, Brain; Peptide Fragments; Pregnancy; Prolactin; Puerperal Disorders; Ventricular Dysfunction, Left

Topics: Adult; Cerebral Angiography; Cerebral Infarction; Drug Therapy, Combination; Ergolines; Ergonovine; Ergotism; Female; Hemiplegia; Humans; Ischemic Attack, Transient; Pregnancy; Puerperal Disorders; Tomography, X-Ray Computed

Topics: Adult; Ergolines; Female; Galactorrhea; Humans; Lactation; Lactation Disorders; Metergoline; Pregnancy; Prolactin; Puerperal Disorders

Bromocriptine 2-5 mg twice daily is effective in the treatment of both normoprolactinaemic and hyperprolactinaemic secondary amenorrhoea. This was demonstrated by the restoration of menstrual cycle and/or ovulation in 9 of 18 normoprolactinaemic and in 8 of 14 hyperprolactinaemic patients taking bromocriptine. Serum-prolactin level decreased in both groups of patients, and usually menstruation was recovered within 8 weeks'treatment. Galactorrhoea disappeared in 7 of 9 hyperprolactinaemic patients, and 2 became pregnant. After treatment had ceased spontaneous menstrual activity continued in 4 patients. 16 patients had side-effects the commonest being nausea and vertigo. These usually disappeared with the dosage was reduced, but 5 patients refused to continue. These results point to a new approach in the treatment of secondary amenorrhoea, even in those patients whose clinical findings give no indication of prolactin suppression.

Topics: Adolescent; Adult; Amenorrhea; Bromocriptine; Drug Evaluation; Ergolines; Female; Follow-Up Studies; Galactorrhea; Humans; Menstruation; Ovulation; Pregnancy; Prolactin; Puerperal Disorders

11 patients suffering from amenorrhea-galactorrhea, and 26 puerperas for whom lactation was not indicated were treated with 2-Br-alpha-ergocryptine. The drug led to a regression of galactorrhea, and to normal menstrual cycles in all patients, except in one who was suffering from hypophyseal adenoma. Lactation was effectively inhibited in all 26 puerperas after only a few days of treatment. Results showed that 2-Br-alpha-ergocryptine has a powerful inhibitory action on the hypophyseal secretion of prolactin, both during puerperium and in nonpuerperal conditions.

Topics: Adult; Amenorrhea; Ergolines; Female; Galactorrhea; Gonadotropins, Pituitary; Humans; Lactation; Lactation Disorders; Pituitary Gland; Pituitary Gland, Anterior; Pregnancy; Prolactin; Puerperal Disorders