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Concurrent parathyroidectomy and caesarean section in the third trimester.
Christopher Trebb1, Sarah Wallace2, Fadel Ishak2
1Northern Ontario School of Medicine, Sudbury ON.
Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'Obstetrique Et Gynecologie Du Canada : JOGC
|June 14, 2014
Summary
Concurrent surgery for hyperparathyroidism during pregnancy is safe. This approach managed a severe case, protecting both mother and baby from complications like hypocalcemia.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Surgical Management
Background:
- Primary hyperparathyroidism is a common cause of hypercalcemia.
- It is a rare but serious pregnancy complication with significant risks to mother and fetus.
- Early recognition and management are crucial.
Observation:
- A 27-year-old primigravida presented with hypercalcemia and HELLP syndrome at 32+3 weeks gestation.
- She underwent a combined Caesarean section and parathyroidectomy.
- Postoperative monitoring showed no hypocalcemia in mother or neonate.
Findings:
- Concurrent parathyroidectomy and Caesarean section is a viable management strategy for third-trimester hyperparathyroidism.
- Pathological analysis revealed atypical parathyroid tissue, necessitating a postpartum hemithyroidectomy.
- This surgical approach effectively resolved maternal hypercalcemia without causing neonatal hypocalcemia.
Implications:
- Concurrent surgery offers a safe and effective solution for managing hyperparathyroidism in late pregnancy.
- Multidisciplinary team involvement and vigilant postoperative calcium monitoring are essential for optimal outcomes.
- This case highlights the importance of considering and managing hyperparathyroidism during pregnancy to prevent adverse maternal and fetal effects.
