Advertisement

O05Cabergoline for lactation inhibition after second-trimester abortion or loss: A randomized controlled trial

      This paper is only available as a PDF. To read, Please Download here.

      Objectives

      To assess cabergoline's efficacy at decreasing lactation after second-trimester abortion or loss.

      Methods

      This is a double-blinded, block-randomized superiority trial (IRB approved, NCT04701333) comparing cabergoline 1mg once to placebo for preventing bothersome breast engorgement after second-trimester uterine evacuation. April 2021-June 2022, we enrolled pregnant people 18-28-weeks gestation, English- or Spanish-speaking, without contraindication to the study drug. Participants completed a validated, piloted, electronic survey at baseline and through two weeks post-procedure assessing breast symptoms, side-effects, and bother at each time point. Our primary outcome is breast symptoms on day 4; we planned to enroll 80 patients to show a 30% difference in breast symptoms (80% power, α = 0.049). A sub-group of participants returned for serum prolactin levels.

      Results

      After screening 150 patients, we enrolled 73 participants. Baseline demographics were balanced between groups: median gestational age 21 weeks (range: 18-26), 56% nulliparous, 35% self-identified as Hispanic, 37% with public insurance. At baseline, reported breast symptoms were similar between groups. At day 4, significantly fewer participants receiving cabergoline reported any symptoms compared to placebo (27.8% vs 97.0%, p<0.0001) and fewer reported significant bother (2.8% vs 29.7%, p=0.002). These differences persisted through day 14. Reported side-effects (p=0.31) were similar between groups: most common were constipation (44%), fatigue (32%), and headache (29%). Serum prolactin was similar at baseline. On day 4, mean serum prolactin was 6.5ng/mL (std dev 2.2) for those receiving cabergoline and 18.0ng/mL (std dev 5.9) for placebo (p=0.04).

      Conclusions

      Cabergoline is an effective strategy to prevent breast symptoms following second-trimester abortion or loss.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Contraception
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect