Cabergoline effective for preventing breast symptoms after abortion, pregnancy loss
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Key takeaways:
- Breast engorgement is common after second-trimester abortion or pregnancy loss.
- Off-label cabergoline was effective and well tolerated for preventing symptomatic breast engorgement.
BALTIMORE — A one-time dose of off-label cabergoline after second-trimester abortion or pregnancy loss was effective for preventing symptomatic breast engorgement, according to data presented at the ACOG Annual Clinical & Scientific Meeting.
“Breast engorgement is common after second-trimester abortion. The severity of bother is underappreciated and undertreated by most providers,” Kate A. Shaw, MD, MS, associate professor of obstetrics and gynecology at Stanford Medicine, said during the late-breaking studies session here.
However, Shaw said, “existing nonpharmacologic interventions have poor evidence for efficacy.”
The researchers conducted a study to evaluate the efficacy of cabergoline 1 mg compared with placebo for decreasing breast symptoms after second-trimester abortion or pregnancy loss. The study enrolled 73 patients with bothersome breast engorgement. Median gestational age was 21 weeks, 56.2% of participants were nulliparous, 34% were Hispanic and 40% were Asian/Pacific Islander, 86% underwent a D&E, 4% had prior breastfeeding experience and 37% had public health insurance.
Results of this phase 3 study were also recently published in Obstetrics & Gynecology.
The presence of self-reported breast symptoms on day 4 was lower among participants who received cabergoline (27.8% vs. 97%; P < .001). In addition, fewer participants reported bother related to their symptoms (2.8% vs. 33.3%; P = .001). The differences in these outcomes persisted through day 14, according to the researchers.
The reported incidence and severity of bother from side effects occurred at a similar rate in both groups. The most common side effects were constipation, fatigue and headache, according to the researchers.