Hyperparathyroidism in pregnancy

Abstract

Primary hyperparathyroidism in pregnancy is uncommon and easily overlooked. It is associated with a complication rate of up to 80 per cent-mainly stillbirths, abortions and neonatal tetany. Surgical treatment during pregnancy offers the best chance for fetal and neonatal survival.

Parathyroid Function and Disease during Pregnancy, Lactation, and Fetal/Neonatal Development

“…142,[145][146][147][148][149] Severe hypercalcemia or parathyroid crisis has also occurred during the third trimester. 147,148,150,151 Fractures are uncommon, likely reflecting the short duration of pregnancy and young age of most pregnant women, but they have occurred during pregnancy with marked hyperparathyroidism or parathyroid carcinoma. 152, 153 The overall impression is that pregnancy may predispose to more severe hypercalcemiarelated manifestations of primary hyperparathyroidism, although reporting bias must also be considered.…”

“…This buffering effect of the placenta will be abruptly lost after delivery, and may explain why hypercalcemic crises are more common postpartum. 150,151,154,155 Physical inactivity and bedrest can cause an additional component of bone resorption to become superimposed during late pregnancy and puerperium. The clinician should beware of the potential for primary hyperparathyroidism to rapidly worsen after delivery.…”

“…147,148,150,151,154 VI. THE PARATHYROIDS AND OSTEOPOROSIS This conceivably results from abrupt loss of the placenta, which represented a significant drain of calcium from the mother.…”

Primary Hyperparathyroidism in Pregnancy

“…Maternal hyperparathyroidism is associated with a neonatal complication rate of between 50% and 80%, including stillbirth, neonatal tetany and death (Ludwig, 1962;Delmonico et al, 1976;Salem and Taylor, 1979).…”

Review of general surgery 1979

“…The non-explored patients would require careful follow-up to detect symptoms and complications for comparison with the surgically treated group. Salem and Taylor (1979) review the uncommon problem of primary hyperparathyroidism in pregnancy. It is associated with a complication rate of up to 80%, mainly stillbirths, abortions and neonatal tetany.…”