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[Primary hyperparathyroidism in the 3d pregnancy trimester]

B Schneider1, T Peschgens, H Hörnchen

  • 1Medizinische Klinik II, Rheinisch-Westfälischen Technischen Hochschule, Aachen.

Deutsche Medizinische Wochenschrift (1946)
|August 18, 1995
PubMed
Summary

Surgical treatment for primary hyperparathyroidism during pregnancy is feasible, even in the third trimester. This intervention safely managed maternal hypercalcemia and allowed for healthy fetal development.

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Area of Science:

  • Endocrinology
  • Obstetrics
  • Surgical Management

Background:

  • Primary hyperparathyroidism (PHP) in pregnancy presents diagnostic challenges.
  • Maternal hypercalcemia can lead to adverse pregnancy outcomes.
  • Nephrolithiasis and pyelonephritis are common complications.

Observation:

  • A 24-year-old pregnant woman presented with premature contractions and pyelonephritis at 33 weeks gestation.
  • Laboratory findings revealed hypercalcemia (3.6 mmol/l), hypophosphatemia (0.59 mmol/l), and elevated parathyroid hormone (420 ng/l).
  • Ultrasonography confirmed a large parathyroid adenoma, diagnosing PHP.

Findings:

  • Parathyroidectomy was successfully performed at 35 weeks gestation without complications.
  • The patient delivered a healthy, mature infant at 41 weeks.

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  • The infant showed no signs of hypoparathyroidism post-delivery.

    • Implications:

    • Surgical intervention for PHP is a viable option during the third trimester of pregnancy.
    • Early surgical management can prevent fetal complications associated with maternal hyperparathyroidism.
    • Individualized treatment decisions are crucial, considering gestational age and disease progression.