Cabergoline for Lactation Inhibition After Second-Trimester Abortion or Pregnancy Loss: A Randomized Controlled Trial.
Level 2 - randomized trial
Individual double-blind randomized controlled trial
PubMed 37486652 · doi:10.1097/AOG.0000000000005190
What was done
This double-blind, block-randomized superiority trial evaluated a single 1 mg dose of cabergoline versus placebo for preventing breast engorgement after second-trimester uterine evacuation. Participants were pregnant people at 18 to 28 weeks of gestation who were English- or Spanish-speaking. Breast symptoms, side effects, and bother were assessed via electronic surveys at baseline and through 2 weeks postprocedure. The primary outcome was any breast symptoms (composite of engorgement, milk leakage, tenderness, and pain relief need) on day 4. A subgroup had serum prolactin measured.
What was found
From 150 screened patients, 73 were enrolled (median gestational age 21 weeks, range 18-26 weeks). Among 69 participants returning day-4 surveys, significantly fewer receiving cabergoline reported any breast symptoms compared with placebo (27.8% vs 97.0%, P < .001) and fewer reported significant bother (2.8% vs 33.3%, P = .001); differences persisted through day 14. Day-4 mean serum prolactin was 6.5 ng/mL (SD 2.2) with cabergoline versus 18.0 ng/mL (SD 5.9) with placebo (P = .049). Reported side-effect incidence and bother (primarily constipation, fatigue, headache) were similar between groups.
Why it matters
A single 1 mg dose of cabergoline effectively suppresses lactation and reduces breast symptoms and related bother after second-trimester pregnancy loss or abortion without increasing side-effect bother.
Limits
The trial did not reach its planned sample size of 80 participants (73 enrolled, 69 completed primary outcome assessment). Follow-up ended at 14 days, and participants were restricted to English- or Spanish-speakers with gestational ages up to 26 weeks in the enrolled cohort.
Cited by
- supports Prescription drugs such as cabergoline inhibit prolactin secretion.