PRIMARY
HYPERPARATHYROIDISM IN PREGNANCY IS POTENTIALLY DANGEROUS AND SHOULD BE PROMPTY
DIAGNOSED AND EFFECTIVELY TREATED
Primary
hyperparathyroidism (PHPT) is commonly (> 80 %) asymptomatic in both the
pregnant and the nonpregnant patient. In these patients, PHPT is diagnosed
incidentally based on the results of laboratory investigation. Especially during
pregnancy, PHPT often goes unrecognized due to the physiological changes of
pregnancy. Hypoalbuminemia, calcium transport across the placenta, and an
increased glomerular filtration rate all contribute to the appearance of lower
serum calcium levels in the pregnant patient. Moreover, there is evidence that estrogen
inhibit parathyroid hormone (PTH)-mediated bone resorption, causing a
dose-related reduction in serum calcium during pregnancy. However, PHPT during
pregnancy should be promptly recognized and appropriately treated, since it is
associated with significant maternal complications (maternal morbidity up to 65
%), including preeclampsia, and fetal complications (fetal morbidity up to 80 %).
Fetal complications are associated with an increased neonatal mortality (up to
30 %).
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