Primary Hyperparathyroidism in Pregnancy: Successful Parathyroidectomy during First Trimester

Tachamo, Niranjan; Timilsina, Bidhya; Dhital, Rashmi; Lynn, Theresa; Magaji, Vasudev; Gabriely, Ilan

doi:10.1155/2018/5493917

Cited by 12 publications

(13 citation statements)

References 11 publications

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“…The treatment of choice is usually parathyroidectomy, preferably at the beginning of the second pregnancy trimester. Conservative treatment may be indicated for patients with mild or asymptomatic symptoms during pregnancy, as well as surgical failure or when facing contraindications [12]. Such patients are then treated with venous hydration with 0.9% saline and calcitonin, as literature points no adverse effects on the fetus [4].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous fractures secondary to primary hyperparathyroidism in pregnancy: a case report / Fracturas espontâneas secundárias ao hiperparatiroidismo primário na gravidez: um relato de caso

Mendonça¹,

Toledo²,

Mendonça³

et al. 2021

BJDV

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Objective: To report a case of hyperparathyroidism secondary to a parathyroid adenoma, presenting a high level of hypercalcemia associated with spontaneous fractures in young pregnant woman. Case report: The patient underwent an emergency cesarean after presenting premature amniorrhexis and tolerated the procedure without complications. The newborn evolved satisfactorily, without symptoms of hypocalcemia. The postpartum woman was then submitted to left lower parathyroidectomy and, in the postoperative period, she developed bone hunger syndrome, despite previous administration of bisphosphonate. There was a progressive resolution of PTH and serum calcium levels, with a consequent improvement in the clinical condition. Conclusion: This report highlights the need and the difficulty regarding the early diagnosis of primary hyperparathyroidism, which is a potentially fatal pathology for the maternal-fetal binomial. Therefore, it is essential to institute proper treatment early, with individualization according to the patient's clinical condition, to minimize the risks of complications and mortality.

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Section: Discussionmentioning

confidence: 99%

Spontaneous fractures secondary to primary hyperparathyroidism in pregnancy: a case report / Fracturas espontâneas secundárias ao hiperparatiroidismo primário na gravidez: um relato de caso

Mendonça¹,

Toledo²,

Mendonça³

et al. 2021

BJDV

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“…Surgery in the second trimester is historically desired due to the lowest surgical and anaesthetic risk. Nevertheless, surgery has been safely performed in the first and third trimesters 18. Timely management is essential to decrease the risks to mother and fetus; however, it does not eliminate the risk entirely 19.…”

Section: Discussionmentioning

confidence: 99%

Hyperparathyroidism in pregnancy

Davis

Nippita

2020

BMJ Case Rep

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Hyperparathyroidism is a rare disease during pregnancy, which has increased risks, including miscarriage and fetal growth restriction. However, the diagnosis of hyperparathyroidism is frequently not recognised or delayed as symptoms are non-specific and calcium is not routinely measured. With a thorough medical history and clinical suspicion, early diagnosis and treatment can reduce the risk of some pregnancy complications. A 35-year-old woman presented at 13/40 with hyperemesis gravidarum. She had elevated serum calcium and a parathyroid lesion on ultrasound. She underwent a parathyroidectomy with rapid normalisation of her calcium. Histopathology confirmed a parafibromin-deficient parathyroid tumour, suggestive of hyperparathyroidism jaw tumour syndrome. At 30/40, she presented with pre-eclampsia (hypertension, hyper-reflexia, proteinuria and intrauterine growth restriction) and had a caesarean section at 30+1/40, delivering a male infant, 897 g (fifth percentile). She had a prior 12-month history of chronic constipation and nephrolithiasis but was not investigated further despite elevated calcium (2.82 mmol/L).

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“…These complications may be attributed to delayed presentation and prolonged exposure to maternal hypercalcemia. Parathyroidectomy has also been performed successfully in the 1st trimester [112].…”

Section: Clinical Management Of Phpt In Pregnancymentioning

confidence: 99%

Primary Hyperparathyroidism in Pregnancy: Literature Review of the Diagnosis and Management

Ali

Dandurand

Khan

2021

JCM

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Background: Parathyroid disease is uncommon in pregnancy. During pregnancy, multiple changes occur in the calcium regulating hormones which may make the diagnosis of primary hyperparathyroidism more challenging. Close monitoring of serum calcium during pregnancy is necessary in order to optimize maternal and fetal outcomes. In this review, we will describe the diagnosis and management of primary hyperparathyroidism during pregnancy. Methods: We searched MEDLINE, CINAHL, EMBASE and Google scholar bases from 1 January 1990 to 31 December 2020. Case reports, case series, book chapters and clinical guidelines were included in this review. Conclusions: Medical management options for primary hyperparathyroidism during pregnancy are severely limited due to inadequate safety data with the various potential therapies available, and surgery is advised during the 2nd trimester of pregnancy in the presence of severe hypercalcemia (calcium adjusted for albumin greater than 3.0 mmol/L (12.0 mg/dL)). Hypercalcemia should be avoided during pregnancy in order to minimize maternal and fetal complications.

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Primary Hyperparathyroidism in Pregnancy: Successful Parathyroidectomy during First Trimester

Cited by 12 publications

References 11 publications

Spontaneous fractures secondary to primary hyperparathyroidism in pregnancy: a case report / Fracturas espontâneas secundárias ao hiperparatiroidismo primário na gravidez: um relato de caso

Spontaneous fractures secondary to primary hyperparathyroidism in pregnancy: a case report / Fracturas espontâneas secundárias ao hiperparatiroidismo primário na gravidez: um relato de caso

Hyperparathyroidism in pregnancy

Primary Hyperparathyroidism in Pregnancy: Literature Review of the Diagnosis and Management

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