Calcium and phosphorus dynamics in pregnancy

Kerr, Carolyn L.; Löken, Hans F.; Glendening, Mary Beth; Gordan, Gilbert S.; Page, Ernest W.

doi:10.1016/0002-9378(62)90278-8

Cited by 27 publications

(9 citation statements)

References 19 publications

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“…Mull and Bill (1934) found a slight (5%) fall in serum calcium levels in pregnancy which rose to normal during the first week post partum; hypercalcaemia was not found. These findings were confirmed by Newman (1947), and, in addition, Kerr et al (1962) showed that the non-protein-bound fraction of the serum calcium remained unchanged. Goss (1962) noted a fall in the urine calcium excretion in late pregnancy under normal diet conditions; though an increase in calcium intake resulted in increased urinary excretion, the serum calcium levels showed little change.…”

Section: Second Pregnancysupporting

confidence: 52%

Post-partum Hypercalcaemia in Treated Hypoparathyroidism

Wright¹,

Joplin²,

Dixon³

1969

BMJ

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Bone Scanning with Strontium-85-Parsons et al.MEDICBL JOURNAL 23 have revealed the presence of bony changes which had been barely visible in previous radiographs. This may reflect the clinicians' poor prediction rather than radiological technique. On occasion, while scanning one area under suspicion another, totally unexpected, area will appear active, and when this is examined radiologically the bony changes are apparent. In this situation scanning has supplemented but in no way replaced radiology. Because of the limited areas scanned in this group of patients, coupled with the frequent occurrence of crush and healing fractures, the biochemical indices of overall bone diseases are difficult to compare with the scanning results. In three patients increased excretion of hydroxyproline containing peptides was the only positive biochemical finding which correlated with a positive scan, and this finding needs to be confirmed in a larger series.Malignancy was suspected in three patients, but biopsy in one showed a tuberculous abscess and in the other two the symptoms receded with antibiotic therapy-a reminder that not all vertebral disease in patients with a past history of malignant disease need be metastatic.

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Section: Second Pregnancysupporting

confidence: 52%

Post-partum Hypercalcaemia in Treated Hypoparathyroidism

Wright¹,

Joplin²,

Dixon³

1969

BMJ

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“…Urine calcium is linearly related to absorption in non-pregnant women, and for absorbed values as high as we found should have been well in excess of 200 mg per day (21). Since plasma ultrafiltrable calcium does not change in pregnancy (22,23), the failure to see frank hypercalciuria suggests increased tubular calcium reabsorption, and is thus compatible with increased parathyroid hormone secretion. Furthermore the fall in urine calcium as gestation advanced, which had earlier been observed by Goss (25), suggests a progressive rise in maternal parathyroid hormone levels as fetal mineralization increases.…”

Section: Discussionmentioning

confidence: 94%

Calcium Metabolism in Normal Human Pregnancy

Heaney

Skillman

1971

The Journal of Clinical Endocrinology & Metabolism

340

105

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Fifteen normal pregnant women and 9 female controls of similar age underwent mineral balance and calcium kinetic studies during and after pregnancy. 48 Ca, a stable isotope, was employed in the pregnant women and specimens were measured by neutron activation analysis. Results were related to stage of pregnancy and demonstrated the expected and well documented retention of nitrogen, phosphorus, and calcium associated with fetal development. In addition, there was a 20% increase in miscible calcium pool by term, and an approximate doubling of both pool turnover and bone mineral accretion rates, both rising progressively with duration of pregnancy. Intestinal calcium absorption was twice usual normal levels from the earliest period studied and remained high throughout pregnancy.Virtually all these changes reverted to normal non-pregnant levels by 3 months after delivery. The importance of maternal adjustments as a component in these changes was emphasized by the presence of significant changes in accretion, turnover, and calcium absorption well in advance of the time when most skeletal mineralization occurs in the fetus and by the partial persistence of elevation of these functions for a few weeks after delivery. High doses of both estrogen and progesterone given to a single normal woman for 7 weeks failed to reproduce the changes observed in actual pregnancy. The basis for these anticipatory maternal adjustments is speculated to be an interaction between placental lactogen, estrogens, and parathyroid hormone. (/ Clin Endocr 33: 661, 1971)

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“…The pattern of calcium level parallels that of albumin in maternal serum. It is generally agreed that the level of ionic calcium does not change during pregnancy (Andersch and Obertst, 1936;Kerr et al, 1962;Reitz et al, 1972), although one study does report a progressive decline in ionized calcium .…”

Section: Vitamin D Calcium and Phosphorusmentioning

confidence: 95%