Cabergoline effective in preventing breast symptoms after abortion, pregnancy loss

Key takeaway :

• Breast engorgement is common after a second trimester abortion or pregnancy loss.
• Off-label cabergoline was effective and well tolerated in preventing symptomatic breast engorgement.

BALTIMORE: A single off-label dose of cabergoline following second-trimester abortion or pregnancy loss was effective in preventing symptomatic breast engorgement, according to data presented at the ACOG Annual Clinical and Scientific Meeting.

“Breast engorgement is common after the second trimester abortion. Most providers underestimate and treat the severity of the complaints,” Kate A. Shaw, MD, MS, associate professor of obstetrics and gynecology at Stanford Medicine, said during the last study session here.

However, Shaw said, “existing non-pharmacological interventions have little evidence of efficacy.”

Investigators conducted a study to assess the efficacy of cabergoline 1 mg compared to placebo in 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% had a D&E, 4% had previous experience with breastfeeding and 37% had public health insurance.

The results of this phase 3 study were also recently published in Obstetrics and Gynecology.

The presence of self-reported breast symptoms on day 4 was lower among participants receiving cabergoline (27.8% vs. 97%; P < .001). In addition, fewer participants reported complaints related to their symptoms (2.8% vs. 33.3%; P = .001). Differences in these outcomes persisted through day 14, according to the researchers.

The reported incidence and severity of bothersome side effects occurred at a similar rate in both groups. The most common side effects were constipation, fatigue and headache, according to the researchers.

Reference:

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Annual Clinical and Scientific Meeting of the American College of Obstetrics and Gynecology