Cushing’s Disease in Pregnancy and Cabergoline Use: Obstetric and Neonatal Outcomes

Abstract

Pregnancy in patients with Cushing’s disease (CD) is rare and is associated with significant maternal and fetal complications. We report a case of CD who achieved uncomplicated pregnancy and delivery after treatment with low-dose cabergoline. A 29-year-old woman was diagnosed with CD (adrenocorticotropic hormone-secreting macrotumor that causes displacement of the optic chiasm, infiltrates the right cavernous sinus, and engulfs the internal carotid artery) and underwent transsphenoidal surgery with incomplete tumor resection. After a year of clinical stability, her symptoms recurred, and cabergoline was initiated. During the treatment, the patient conceived, and the medication was suspended. In the first trimester, clinical and biochemical parameters indicate active CD, so cabergoline was reinstated at a low dose for the rest of the pregnancy. With the dopaminergic agonist, her clinical and laboratory parameters normalized, and the patient gave birth to a healthy girl at 38 weeks, within normal percentiles and without complications. Pregnancy in patients diagnosed with CD is a rare event, and the consequences of maternal-fetal exposure to hypercortisolism can be severe. Our experience with the use of cabergoline at low doses in a pregnant woman with CD contributes favorable data to the scarce existing literature reports, adding evidence on the safety profile of the drug in this population.