Cushing's disease in pregnancy and treatment with cabergoline

obstetric and neonatal results

Abstract

Introduction: Cushing's disease (CD) is rare during pregnancy and is associated with significant maternal and fetal complications. The aim was to report the case of a patient with CD who achieved pregnancy and delivery without complications after treatment with low doses of cabergoline. Methods: A 29-year-old woman diagnosed with CD (ACTH-secreting macroadenoma that produces displacement of the optic chiasm, infiltrates the right cavernous sinus and includes the internal carotid artery). She undergoes transsphenoidal surgery with incomplete tumor resection. After a year of clinical stability, the symptoms reappeared, so medical treatment with cabergoline was established. Results: At the first trimester, clinical and biochemical parameters indicate active CD, so it was decided to readminister Cabergoline at low doses for the rest of the pregnancy. The response to dopaminergic agonists was excellent, and the laboratories were normalized, and the disease was controlled. The patient delivered a healthy girl at 38-week-old, with normal percentiles and without complications. Conclusion: Pregnancy is rare in patients with CD. However, the consequences of maternal-fetal exposure to hypercortisolism can be serious. Our experience with the use of low-dose cabergoline in a pregnant woman with CD provides favourable data to the few existing bibliographic reports, adding evidence on the safety profile of the drug in this group of patients.