![]() ![]() Reduction mammoplasty after involution is complete gives the best results. Involution after delivery is unpredictable. Suppression of lactation in the puerperium is mandatory with bromocriptine, as further engorgement may precipitate infection and necrosis. The decision to perform a biopsy is difficult as it can cause ulceration and haemorrhage. Rarely fibrocystic disease or cancer may be associated findings. Histology of affected breasts reveals glandular hyperplasia and overgrowth of connective tissue with absence of adipose tissue. Infection and malignancy should be excluded in these cases. Rarely bilateral mastectomy may be needed but there is danger of massive haemorrhage. Termination of pregnancy in first trimester may be needed if the skin overlying the hypertrophied breast gets severely ulcerated and necrosed. Adequate breast support and prolonged bromocriptine therapy is the most consistent conservative therapy. 2 Gravidic macromastia is a psychologically and physically disabling condition. It can occur in any pregnancy, unilaterally or bilaterally, with capacity to recur in all subsequent pregnancies. 1 The aetiology remains unknown, but since the condition occurs within days of conception, it may represent hypersensitivity of breast tissue to chorionic gonadotrophin hormone. It is a very rare disorder with less than 125 cases reported in the literature. Massive hypertrophy of the breast seems to occur only in adolescence and pregnancy. A favourable outcome can be achieved with prompt recognition of the condition, avoiding unnecessary investigations and conservative approach in selected cases. We decided to write the report so that practising gynaecologists and obstetricians become more confident in managing such a rare condition. We report a case of gestational gigantomastia, the only one seen in our institution over the last 20 years, to highlight the management challenges. 1 Postpartum lactation suppression 3 and reduction mammoplasty after complete involution gives optimum results. First trimester pregnancy termination and urgent mastectomy may be needed if fatal complications occur. 2 Management in pregnancy includes adequate breast support and bromocriptine. Rapid enlargement of breasts causes pain, ulceration, necrosis, infection and haemorrhage. It accounts for physical and psychological maternal morbidity. 1 Management in pregnancy is controversial and challenging. Massive hypertrophy of the breasts in pregnancy is a very rare condition (1 in 100 000) of undetermined aetiology. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |