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Hypercalcemia in Pregnancy.

Karel Dandurand1, Dalal S Ali1, Aliya A Khan1

  • 1Division of Endocrinology and Metabolism, McMaster University, Bone Research and Education Centre, 3075 Hospital Gate, Unit 223, Oakville, ON L6M 1M1, Canada.

Endocrinology and Metabolism Clinics of North America
|November 14, 2021
PubMed
Summary
This summary is machine-generated.

Hypercalcemia in pregnancy, often from primary hyperparathyroidism, presents subtly. Early diagnosis and treatment, including parathyroidectomy for severe cases, are crucial for maternal and fetal health.

Keywords:
CalcitoninCinacalcetHypercalcemiaManagementParathyroidectomyPregnancyPrimary hyperparathyroidism

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Area of Science:

  • Endocrinology
  • Obstetrics
  • Maternal-Fetal Medicine

Background:

  • Hypercalcemic disorders are rare during pregnancy, typically caused by primary hyperparathyroidism.
  • Physiologic changes in pregnancy can mask nonspecific clinical signs of hypercalcemia, delaying diagnosis.
  • Routine antenatal screening lacks serum calcium measurement, potentially postponing diagnosis until delivery.

Purpose of the Study:

  • To highlight the diagnostic challenges and management strategies for hypercalcemia in pregnant women.
  • To emphasize the importance of timely recognition and intervention to prevent maternal and fetal complications.

Main Methods:

  • Review of clinical manifestations and diagnostic considerations of hypercalcemia in pregnancy.
  • Discussion of conservative management for mild cases and surgical intervention for severe, unresponsive primary hyperparathyroidism.

Main Results:

  • Clinical symptoms of hypercalcemia can be nonspecific and mimicked by normal pregnancy changes.
  • Delayed diagnosis is common due to lack of routine screening and symptom masking.
  • Conservative measures are effective for mild hypercalcemia, while parathyroidectomy is the definitive treatment for significant cases.

Conclusions:

  • Prompt diagnosis and management of hypercalcemia are vital to mitigate risks to both mother and fetus.
  • Parathyroidectomy is the established treatment for significant primary hyperparathyroidism-induced hypercalcemia unresponsive to conservative care.