Pregnancy with primary hyperparathyroidism

IF 6.1 1区医学 Q1 ENDOCRINOLOGY & METABOLISM

Best practice & research. Clinical endocrinology & metabolism Pub Date : 2025-03-01 DOI:10.1016/j.beem.2025.101983

Rimesh Pal , Soham Mukherjee , Trupti N. Prasad , Sanjay Kumar Bhadada

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引用次数: 0

Abstract

Primary hyperparathyroidism (PHPT) in pregnancy is rare. The physiological changes that occur in pregnancy often tend to mask the symptoms of PHPT, thereby making diagnosis challenging. If left undiagnosed, PHPT can lead to significant feto-maternal morbidity, which, primarily depends on maternal serum calcium levels. Maternal serum calcium > 11.4 mg/dl increases the risk of incident maternal and fetal complications. The diagnosis of PHPT in pregnancy is based on the documentation of parathyroid hormone-dependent hypercalcemia. Ultrasonography can be safely used to localize the culprit parathyroid lesions; other imaging modalities entailing the risk of exposure to ionizing radiation should preferably be avoided. Treatment involves parathyroid surgery (preferably performed in the second trimester) and/or medical management (hydration, use of calcium-lowering drugs like calcitonin and/or cinacalcet) and should be tailored to the term of pregnancy, severity of hypercalcemia, potential maternal-foetal risks involved, available surgical expertise and patient’s choices.

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妊娠伴有原发性甲状旁腺功能亢进。

原发性甲状旁腺功能亢进（PHPT）在妊娠是罕见的。怀孕期间发生的生理变化往往会掩盖PHPT的症状，从而使诊断具有挑战性。如果不及时诊断，PHPT可导致严重的胎母发病率，这主要取决于母体血清钙水平。母体血清钙> 11.4 mg/dl增加发生母体和胎儿并发症的风险。妊娠期PHPT的诊断是基于甲状旁腺激素依赖性高钙血症的记录。超声可以安全地定位甲状旁腺病变的罪魁祸首；最好避免其他有暴露于电离辐射危险的成像方式。治疗包括甲状旁腺手术（最好在妊娠中期进行）和/或医疗管理（水合作用，使用降钙素和/或cinacalcet等降钙药物），并应根据妊娠期、高钙血症的严重程度、涉及的潜在母婴风险、可用的外科专业知识和患者的选择进行量身定制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Best practice & research. Clinical endocrinology & metabolism 医学-内分泌学与代谢

CiteScore

11.90

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Best Practice & Research Clinical Endocrinology & Metabolism is a serial publication that integrates the latest original research findings into evidence-based review articles. These articles aim to address key clinical issues related to diagnosis, treatment, and patient management. Each issue adopts a problem-oriented approach, focusing on key questions and clearly outlining what is known while identifying areas for future research. Practical management strategies are described to facilitate application to individual patients. The series targets physicians in practice or training.