A study showed that women who have had a second-trimester pregnancy or abortion can reduce the symptoms of breast engorgement, including those related to lactation.
Researchers conducted a double-blinded, block-randomized superiority trial involving pregnant people at 18–28 weeks of gestation without contraindication to cabergoline. The participants were randomly allocated to receive either cabergoline (1 mg) or a placebo. The participants completed a validated survey on breast symptoms and side effects at the baseline, as well as at several timepoints up to 2 weeks following treatment.
The primary outcome was the presence of breast symptoms on day 4 (a composite consisting of engorgement and milk leakage as well as tenderness or a need for pain relief), while a secondary outcome was the degree to which patients were bothered. A subgroup of participants had their serum prolactin measured.
The analysis included a total of 73 participants. (Median age 33 years; median gestational period 21 weeks). Of the 73 participants, 56,2 percent were nulliparous. 34,2 percent identified themselves as Hispanic and 37,0 percent had public health insurance. The treatment groups reported similar breast symptoms.
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 continued to day 14.
Constipation and fatigue were the most commonly reported side effects.
Finaly, the serum prolactin was similar at baseline and significantly lower at day 4 with cabergoline (mean 6.5 vs. 18 ng/mL p=0.049) than with placebo.
