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Ведение пациенток с пролактиномами после родоразрешения.
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В литературе отсутствуют данные, указывающие на прогрессирование аденом во время грудного вскармливания. Комплексное клинико-рентгенологическое обследование пациенток с гиперпролактинемией после родов и периода лактации не выявило отрицательной динамики заболевания.
3.3.1 Среди пациенток с гиперпролактинемией целесообразно ограничить период кормления до 6-12 месяцев, а в некоторых случаях отказаться от него.
(уровень доказательности 3, класс рекомендаций В)
В ряде случаев после беременности наблюдается спонтанная ремиссия заболевания, в возобновлении лечения такие пациентки не нуждаются, однако дальнейшее наблюдение следует проводить в течение как минимум 5 лет.
Ведение пациенток с пролактиномами в постменопаузе.
Ведение пациенток с макропролактиномами в постменопаузе не отличается от такового в остальных возрастных группах.
У пациенток с микропролактиномами возможна отмена терапии с дальнейшим динамическим контролем в течение 5 лет
(уровень доказательности 3, класс рекомендаций С)
Литература.
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