Mussa H Almalki MBBS, SSC-MED, CABM, MHSc 1, 2 Ehud Ur MBBS, FRCP 1 Michelle Johnson MD, FRCPC 1 David B Clarke MD, Ph D, FRCSC, FACS 3 Syed A Imran MBBS, FRCP (Edin), FRCPC 3 Division of Endocrinology and Metabolism, University of British Columbia, Vancouver, British Columbia, Canada 1 . Diabetes Center, King Fahad Medical City, Riyadh, Saudi Ara- bia 2 . Divisions of Neurosurgery and Endocri- nology and Metabolism, Dalhousie University, Halifax, Nova Scotia, Canada 3 Management of prolactinomas during pregnancy – A survey of four Canadian provinces Abstract Purpose: e guidelines for management of prolactinomas during pregnancy are mostly based on retrospective evidence or expert opinion. We conducted a survey to assess the current trends in management of prolactinomas during pregnancy. Methods: A case-based electronic questionnaire was sent in January 2011 to all practicing endocrinologists, in four Canadian provinces: Nova Scotia, New Brunswick, Prince Ed- ward Island and British Columbia with three cases of varying severity; ranging from a mi- croprolactinomas to a large macroprolactinomas compressing the optic chiasm. Result: ere was a considerable diversity among endocrinologists with regards to moni- toring and managing prolactinomas during pregnancy. In case of microprolactinomas, 94% of specialists would discontinue dopamine agonist (DA) therapy upon confirmation of pregnancy, 79% would discontinue serum prolactin measurement during pregnancy, and 94% would not perform routine pituitary imaging in the absence of new symptoms whereas 32% would perform regular formal visual field (VF) testing throughout preg- nancy. In the case of macroprolactinomas, 65% chose to discontinue DA therapy upon confirmation of pregnancy, 30% would either perform regular MRI during pregnancy or, if serum prolactin was thought to be elevated out of proportion, with clinical judgment and 40% would not perform regular formal VF monitoring during pregnancy. In management of large macroprolactinomas, 82% elected to continue DA therapy whereas 18% chose surgical excision as the treatment of choice. Forty nine percent would perform regular MRI during pregnancy and 94% would perform regular formal VF monitoring during pregnancy. Conclusion: Among endocrinologists there is considerable diversity in management of prolactinomas during pregnancy, indicating a need for better consensus and clearer guidelines. ORIGINAL RESEARCH © 2012 CIM Clin Invest Med • Vol 35, no 2, April 2012 E96 Correspondence to: Dr. S A Imran Division of Endocrinology and Metabolism 1276 South Street, Halifax, NS Canada B3H 2Y9 Email: ali.imran@cdha.nshealth.ca Manuscript submitted 5th December, 2011 Manuscript accepted 29th January, 2012 Clin Invest Med 2012; 35 (2): E96-E104.