Clinical Presentation, Management, and Outcomes of Primary Hyperparathyroidism during Pregnancy

Background. Primary hyperparathyroidism (pHPT) in pregnancy is a rare event, but it poses a significant risk to mothers and fetuses. The optimal treatment strategy remains controversial. Methods. We present a consecutive series of twelve pregnant women with pHPT. Results. Twelve women were diagnosed...

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Bibliographic Details
Published in:International Journal of Endocrinology 2017-01, Vol.2017 (2017), p.1-7
Main Authors: Zhao, Yupei, Gao, Xiang, Su, Zhe, Sun, Zhengyi, Cui, Ming, Hu, Ya, Liao, Quan
Format: Article
Language:English
Subjects:
Abortion
Age
Bisphosphonates
Consciousness
Eclampsia
Endocrinology
Fainting
Fetuses
Hospitals
Hydration
Hyperparathyroidism
Hypertension
Medical treatment
Pancreatitis
Patients
Postpartum period
Preeclampsia
Pregnancy
Pregnant women
Surgery
Tumors
Ultrasonic imaging
Vomiting
Womens health
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Summary:Background. Primary hyperparathyroidism (pHPT) in pregnancy is a rare event, but it poses a significant risk to mothers and fetuses. The optimal treatment strategy remains controversial. Methods. We present a consecutive series of twelve pregnant women with pHPT. Results. Twelve women were diagnosed with pHPT during pregnancy or in the postpartum period. Four of them presented no symptoms or mild symptoms. Four patients experienced serious complications, including hypercalcaemic crisis, acute pancreatitis, and eclampsia. Another four patients were identified postpartum as the result of neonatal convulsion with hypocalcaemia. Minimally invasive parathyroidectomy (MIP) under cervical plexus block was successfully performed in 11 of them during pregnancy or postpartum. The serum levels of ionized calcium and intact parathyroid hormone (iPTH) were much higher in patients with severe complications in this cohort than those in the group of patients with no symptoms or mild symptoms and patients who were diagnosed postpartum. Conclusions. MIP under cervical plexus block might be a safe and effective treatment for pregnant women with pHPT. Even though both conservative and surgical treatments are applicable for most mothers and fetuses with asymptomatic and mild hyperparathyroidism, serious complications may have catastrophic consequences for both.
ISSN:1687-8337
1687-8345
DOI:10.1155/2017/3947423