Hyperparathyroidism in Pregnancy

Salem, Richard; Taylor, Selwyn

doi:10.1097/00006254-198006000-00008

Cited by 1 publication

(3 citation statements)

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“…Conversely, rapid placental calcium transfer and uptake of calcium by the fetal skeleton during the third trimester may help protect against severe hypercalcemia in the mothers. Loss of outflow to the placenta likely explains why hypercalcemic crises have occurred after delivery of the placenta (612,662,701,795). Physical inactivity and bedrest will add an additional component of skeletal resorption.…”

Section: Mineral Metabolism During Pregnancy and Lactationmentioning

confidence: 99%

“…In up to 15% of cases women presented with pancreatitis during the second or third trimester (153,186,205,429,508,511). Hypercalcemic crises have occurred during the third trimester (153,186,662,795), which coincides with peak release of PTHrP by the placenta and breasts. There are risks to the fetus and neonate that must be considered, including miscarriage, stillbirth, and hypoparathyroidism, and these are discussed in more detail in the companion review (492).…”

Section: Mineral Metabolism During Pregnancy and Lactationmentioning

confidence: 99%

“…Severe hypercalcemia, also termed a parathyroid crisis, has occurred during the postpartum interval in women with primary hyperparathyroidism who were not operated on during pregnancy, and in some women who go on to breastfeed (54,153,186,612,662,795). The sudden rise in serum calcium likely results from several factors, including abrupt loss of the placenta (a significant route of calcium loss), the initiation of low estradiol and PTHrP-induced skeletal resorption to support milk production, the effect of low estradiol to increase skeletal sensitivity to excess PTH, and physiological resorption induced by physical inactivity and bedrest during the puerperium.…”

Section: Human Datamentioning

confidence: 99%

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Maternal Mineral and Bone Metabolism During Pregnancy, Lactation, and Post-Weaning Recovery

Kovacs

2016

Physiological Reviews

366

524

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During pregnancy and lactation, female physiology adapts to meet the added nutritional demands of fetuses and neonates. An average full-term fetus contains ϳ30 g calcium, 20 g phosphorus, and 0.8 g magnesium. About 80% of mineral is accreted during the third trimester; calcium transfers at 300-350 mg/day during the final 6 wk. The neonate requires 200 mg calcium daily from milk during the first 6 mo, and 120 mg calcium from milk during the second 6 mo (additional calcium comes from solid foods). Calcium transfers can be more than double and triple these values, respectively, in women who nurse twins and triplets. About 25% of dietary calcium is normally absorbed in healthy adults. Average maternal calcium intakes in American and Canadian women are insufficient to meet the fetal and neonatal calcium requirements if normal efficiency of intestinal calcium absorption is relied upon. However, several adaptations are invoked to meet the fetal and neonatal demands for mineral without requiring increased intakes by the mother. During pregnancy the efficiency of intestinal calcium absorption doubles, whereas during lactation the maternal skeleton is resorbed to provide calcium for milk. This review addresses our current knowledge regarding maternal adaptations in mineral and skeletal homeostasis that occur during pregnancy, lactation, and post-weaning recovery. Also considered are the impacts that these adaptations have on biochemical and hormonal parameters of mineral homeostasis, the consequences for long-term skeletal health, and the presentation and management of disorders of mineral and bone metabolism.

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Section: Mineral Metabolism During Pregnancy and Lactationmentioning

confidence: 99%