Jessica Gehlert1, Adam Morton2. 1. Endocrinology Department, Flinders Medical Centre, Bedford Park, Australia. 2. Obstetric Medicine and Endocrinology, Mater Health, Brisbane, Australia.
Abstract
INTRODUCTION: Asymptomatic mild primary hyperparathyroidism is increasingly being identified during pregnancy. Recent studies have demonstrated inconsistent findings with regard to pregnancy complications and the need for surgical intervention during pregnancy. METHOD: A retrospective audit of outcomes of pregnancies complicated by hypercalcaemia over a 15-year period was performed. RESULTS: Twenty-nine pregnancies to 26 women with hypercalcaemia were identified, corresponding to 37 cases per 100,000 deliveries. Hypercalcaemia was due to primary hyperparathyroidism in 90% of cases, with mean serum calcium of 2.89 mmol/l and mean ionised calcium 1.43 mmol/l. Four women underwent successful neck exploration during pregnancy. Pregnancy complications were limited to three cases of pre-eclampsia and one case of symptomatic neonatal hypoparathyroidism. CONCLUSION: Close observation without surgical intervention would seem reasonable in women with mild hypercalcaemia during pregnancy.
INTRODUCTION: Asymptomatic mild primary hyperparathyroidism is increasingly being identified during pregnancy. Recent studies have demonstrated inconsistent findings with regard to pregnancy complications and the need for surgical intervention during pregnancy. METHOD: A retrospective audit of outcomes of pregnancies complicated by hypercalcaemia over a 15-year period was performed. RESULTS: Twenty-nine pregnancies to 26 women with hypercalcaemia were identified, corresponding to 37 cases per 100,000 deliveries. Hypercalcaemia was due to primary hyperparathyroidism in 90% of cases, with mean serum calcium of 2.89 mmol/l and mean ionised calcium 1.43 mmol/l. Four women underwent successful neck exploration during pregnancy. Pregnancy complications were limited to three cases of pre-eclampsia and one case of symptomatic neonatal hypoparathyroidism. CONCLUSION: Close observation without surgical intervention would seem reasonable in women with mild hypercalcaemia during pregnancy.
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