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Mussa H Almalki MBBS, SSC-MED, CABM, MHSc1, 2Ehud Ur MBBS, FRCP1Michelle Johnson MD, FRCPC1David B Clarke MD, Ph D, FRCSC, FACS3Syed A Imran MBBS, FRCP (Edin), FRCPC3Division of Endocrinology and Metabolism, University of British Columbia, Vancouver, British Columbia, Canada1. Diabetes Center, King Fahad Medical City, Riyadh, Saudi Ara-bia2. Divisions of Neurosurgery and Endocri-nology and Metabolism, Dalhousie University, Halifax, Nova Scotia, Canada3 Management of prolactinomas during pregnancy – A survey of four Canadian provincesAbstractPurpose: 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 conrmation 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 eld (VF) testing throughout preg-nancy. In the case of macroprolactinomas, 65% chose to discontinue DA therapy upon conrmation 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 CIMClin Inest Med • V ol 35, no 2, April 2012E96Correspondence to:Dr. S A ImranDivision of Endocrinology and Metabolism1276 South Street, Halifax, NS CanadaB3H 2Y9Email: ali.imran@cdha.nshealth.caManuscript submitted 5th December, 2011 Manuscript accepted 29th January, 2012 Clin Inest Med 2012; 35 (2): E96-E104.