Cabergoline helps prevent lactation after pregnancy loss

Treatment with cabergoline appears to reduce breast engorgement and other symptoms related to lactation in women following second-trimester abortion or pregnancy loss, as shown in a study.

Researchers conducted a double-blinded, block-randomized superiority trial involving pregnant people at 18–28 weeks of gestation without contraindication to cabergoline. These participants were randomly assigned to receive cabergoline 1 mg once or placebo. All of them completed a validated electronic survey at baseline and at multiple timepoints through 2 weeks after treatment to assess breast symptoms, side effects, and bother.

The primary endpoint was any breast symptoms (a composite of engorgement, milk leakage, tenderness, and need for pain relief) on day 4, while the secondary outcome was significant bother. Serum prolactin levels were measured in a subgroup of participants.

A total of 73 participants (median age 33 years, median gestational age 21 weeks) were included in the analysis. Of these, 56.2 percent were nulliparous, 34.2 percent self-identified as Hispanic, and 37.0 percent had public insurance. Reported breast symptoms at baseline were similar between the treatment groups.

Among the 69 participants who returned surveys on day 4, significantly fewer of those who received cabergoline vs placebo reported any breast symptoms (27.8 percent vs 97.0 percent; p<0.001) as well as experiencing significant bother (2.8 percent vs 33.3 percent; p=0.001). These differences persisted through day 14.

No significant between-group differences were seen in the reported incidence and severity of bother from side effects, the most common of which were constipation, fatigue, and headache.

Finally, serum prolactin levels were similar at baseline but were significantly lower with cabergoline than with placebo at day 4 (mean, 6.5 vs 18.0 ng/mL; p=0.049).