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| Octreotide LAR treatment throughout pregnancy in an acromegalic woman
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Objective: Efficacy and safety of Parlodel (PLO) and Sandostatin LAR (SAS LAR) therapy throughout a successful pregnancy in a pat. with acromegaly. Case report.
Subjects: 1 pat., a woman aged 24 years. Case report.
Indications: acromegaly (1)
Dosage/Duration: initially 10 mg as i.m. injection every 4 weeks, then 20 mgevery 4 weeks, reduced to 10 mg every 4 weeks. Duration:>40 weeks.
Free Text: Tests: growth hormone (GH), insulin like growth factor 1 (IGF-1), clinical symptoms (sweating, joint pain), fetal diameter on ultrasound, biopsy of placenta, SAS levels in maternal and cord blood, fetal TSH and IGF-1, Apgar scores, child's height and weight. Additional therapy: surgery, radiotherapy, Parlodel (PLO) 7.5 mg/day, ovulation induction with gonadotrophins, insemination. It is not stated whether PLO therapy was continued throughout pregnancy in this pat. SAS or lanreotide therapy of pat. with acromegaly during pregnancy is reviewed in a table with reference to cases reported in SAS 655, SAS 1249, SAS 3422, SAS 4236, SAS 4398, SAS 4770, SAS 4780 and SAS 5112.
Results: After surgery and radiotherapy, pat. received PLO; during 12 months GH fell from 600 to 60 mU/l with IGF-1 about 185 nmol/l. SAS LAR was added to PLO; GH fell to 26 mU/l, IGF-1 fell to 133 nmol/l and symptoms improved. Pat. became pregnant; at the end of the first trimester, SAS LAR dose was increased; GH fell to 16 mU/l, IGF-1 to 16 mU/l. Fetal growth retardation was suspected at week 21 of gestation and SAS LAR dose was reduced. Female infant (birth weight 2830 g) was delivered by caesarean section at week 38. Apgar scores were 8 and 10 at 1 and 10 minutes, resp. SAS levels were 353 and 1009 pg/ml in fetal and maternal plasma, resp. but fetal TSH and IGF-1 were normal. Placenta was normal. Child has developed normally up to age 18 months.
Side Effects: fetal growth retardation (1?)
Author(s) Conclusion: Octreotide treatment in pregnancy seems to be feasible and safe.
Number of Cases: 1
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