Diagnosis and treatment of pregnancy with primary hyperparathyroidism

doi:10.3877/cma.j.issn.2095-3259.2023.04.004

Abstract

Abstract:

Primary hyperparathyroidism (PHPT) is a rare complication of pregnancy. The incidence rate is about 0.03%-0.05%. The clinical manifestations are different and can involve multiple organs and systems. In some aspects, it is similar to the physiological response of pregnancy and is difficult to distinguish. The laboratory examination shows hypercalcemia, hypophosphatemia, and elevated blood PTH. Ultrasound is the preferred imaging examination during pregnancy, which can identify and locate abnormal parathyroid tissue. Magnetic resonance imaging helps determine the degree of the lesion, and X-ray imaging and nuclide imaging should be avoided. Parathyroidectomy is the first choice for the treatment of PHPT during pregnancy. The operation time should be in the second trimester of pregnancy. After the operation, attention should be paid to the prevention of hypocalcemia in pregnant women and perinatal infants. For mild to moderate PHPT, conservative management can be selected. Fluid replacement, volume expansion and diuresis are helpful in reducing hypercalcemia. Drug treatment is severely limited due to the lack of safety data for drug use during pregnancy.

Key words: Hyperparathyroidism, Pregnancy, Diagnosis, Therapeutics

Yifeng Zhong, Jinsong Gao. Diagnosis and treatment of pregnancy with primary hyperparathyroidism[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2023, 12(04): 206-211.

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