Clinical Presentation, Management, and Outcomes of Primary Hyperparathyroidism during Pregnancy

Ya Hu, Ming Cui, Zhengyi Sun, Zhe Su, Xiang Gao, Quan Liao, Yupei Zhao

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background. Primary hyperparathyroidism (pHPT) in pregnancy is a rare event, but it poses a significant risk to mothers and fetuses. The optimal treatment strategy remains controversial. Methods. We present a consecutive series of twelve pregnant women with pHPT. Results. Twelve women were diagnosed with pHPT during pregnancy or in the postpartum period. Four of them presented no symptoms or mild symptoms. Four patients experienced serious complications, including hypercalcaemic crisis, acute pancreatitis, and eclampsia. Another four patients were identified postpartum as the result of neonatal convulsion with hypocalcaemia. Minimally invasive parathyroidectomy (MIP) under cervical plexus block was successfully performed in 11 of them during pregnancy or postpartum. The serum levels of ionized calcium and intact parathyroid hormone (iPTH) were much higher in patients with severe complications in this cohort than those in the group of patients with no symptoms or mild symptoms and patients who were diagnosed postpartum. Conclusions. MIP under cervical plexus block might be a safe and effective treatment for pregnant women with pHPT. Even though both conservative and surgical treatments are applicable for most mothers and fetuses with asymptomatic and mild hyperparathyroidism, serious complications may have catastrophic consequences for both.

Original languageEnglish (US)
Article number3947423
JournalInternational Journal of Endocrinology
Volume2017
DOIs
StatePublished - Jan 1 2017

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Primary Hyperparathyroidism
Postpartum Period
Pregnancy
Parathyroidectomy
Pregnant Women
Fetus
Mothers
Eclampsia
Hypocalcemia
Hyperparathyroidism
Parathyroid Hormone
Pancreatitis
Seizures
Calcium
Therapeutics
Serum

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology
  • Endocrine and Autonomic Systems

Cite this

Hu, Ya ; Cui, Ming ; Sun, Zhengyi ; Su, Zhe ; Gao, Xiang ; Liao, Quan ; Zhao, Yupei. / Clinical Presentation, Management, and Outcomes of Primary Hyperparathyroidism during Pregnancy. In: International Journal of Endocrinology. 2017 ; Vol. 2017.
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Clinical Presentation, Management, and Outcomes of Primary Hyperparathyroidism during Pregnancy. / Hu, Ya; Cui, Ming; Sun, Zhengyi; Su, Zhe; Gao, Xiang; Liao, Quan; Zhao, Yupei.

In: International Journal of Endocrinology, Vol. 2017, 3947423, 01.01.2017.

Research output: Contribution to journalArticle

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AU - Zhao, Yupei

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N2 - Background. Primary hyperparathyroidism (pHPT) in pregnancy is a rare event, but it poses a significant risk to mothers and fetuses. The optimal treatment strategy remains controversial. Methods. We present a consecutive series of twelve pregnant women with pHPT. Results. Twelve women were diagnosed with pHPT during pregnancy or in the postpartum period. Four of them presented no symptoms or mild symptoms. Four patients experienced serious complications, including hypercalcaemic crisis, acute pancreatitis, and eclampsia. Another four patients were identified postpartum as the result of neonatal convulsion with hypocalcaemia. Minimally invasive parathyroidectomy (MIP) under cervical plexus block was successfully performed in 11 of them during pregnancy or postpartum. The serum levels of ionized calcium and intact parathyroid hormone (iPTH) were much higher in patients with severe complications in this cohort than those in the group of patients with no symptoms or mild symptoms and patients who were diagnosed postpartum. Conclusions. MIP under cervical plexus block might be a safe and effective treatment for pregnant women with pHPT. Even though both conservative and surgical treatments are applicable for most mothers and fetuses with asymptomatic and mild hyperparathyroidism, serious complications may have catastrophic consequences for both.

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