Muhammad Fahad Arshad1,2, Maulee Hiromi Arambewela3,4, William M Bennet3, Monique Sterrenburg3, Saba P Balasubramanian5,3. 1. Oncology and Metabolism, University of Sheffield Medical School, Sheffield, S10 2RX, UK. m.arshad@sheffield.ac.uk. 2. Sheffield Teaching Hospitals, Royal Hallamshire Hospital, Sheffield, S10 2JF, UK. m.arshad@sheffield.ac.uk. 3. Sheffield Teaching Hospitals, Royal Hallamshire Hospital, Sheffield, S10 2JF, UK. 4. University of Sri Jayewardenepura, Nugegoda, Sri Lanka. 5. Oncology and Metabolism, University of Sheffield Medical School, Sheffield, S10 2RX, UK.
Abstract
BACKGROUND AND PURPOSE: The management of primary hyperparathyroidism (PHPT) during pregnancy is challenging and there is no clear consensus on whether it increases the risk of complications in pregnancy. We conducted this study to review the maternal and fetal outcomes of pregnant women treated for PHPT in a single centre. METHODS: Data on relevant clinical parameters, demographics, management strategies, maternal and fetal outcomes were collected from the medical records of pregnant patients with PHPT diagnosed between 2012 and 2019. RESULTS: Of 15 pregnant women with PHPT, 6 were managed medically and 9 underwent surgery. The median age at their index pregnancy was 28 years [range 19-42]. The median highest adjusted calcium level in the medical group was 2.90 [range 2.61-3.25] mmol/L vs. 3.11 [2.78-4.95] mmol/L in the surgical group. There was one miscarriage and the stillbirth of twins in the medical group, but no such outcomes in the surgical group. The median gestational ages were 39 + 3 weeks [range 24 + 2-41 + 2 weeks] and 39 + 4 weeks [range 37 + 1-39 + 5 weeks] in the medical and surgical groups, respectively. No birth was complicated by neonatal tetany or convulsions. CONCLUSION: More complications developed in the pregnant PHPT patients who were managed medically than in those who underwent surgery. Surgery performed during the second trimester resulted in good outcomes. Multi-centre prospective studies are required to ascertain the risk of various complications in women with PHPT during pregnancy.
BACKGROUND AND PURPOSE: The management of primary hyperparathyroidism (PHPT) during pregnancy is challenging and there is no clear consensus on whether it increases the risk of complications in pregnancy. We conducted this study to review the maternal and fetal outcomes of pregnant women treated for PHPT in a single centre. METHODS: Data on relevant clinical parameters, demographics, management strategies, maternal and fetal outcomes were collected from the medical records of pregnant patients with PHPT diagnosed between 2012 and 2019. RESULTS: Of 15 pregnant women with PHPT, 6 were managed medically and 9 underwent surgery. The median age at their index pregnancy was 28 years [range 19-42]. The median highest adjusted calcium level in the medical group was 2.90 [range 2.61-3.25] mmol/L vs. 3.11 [2.78-4.95] mmol/L in the surgical group. There was one miscarriage and the stillbirth of twins in the medical group, but no such outcomes in the surgical group. The median gestational ages were 39 + 3 weeks [range 24 + 2-41 + 2 weeks] and 39 + 4 weeks [range 37 + 1-39 + 5 weeks] in the medical and surgical groups, respectively. No birth was complicated by neonatal tetany or convulsions. CONCLUSION: More complications developed in the pregnant PHPT patients who were managed medically than in those who underwent surgery. Surgery performed during the second trimester resulted in good outcomes. Multi-centre prospective studies are required to ascertain the risk of various complications in women with PHPT during pregnancy.
Authors: Carmen Horjus; Inge Groot; Darryl Telting; Petra van Setten; Adriaan van Sorge; Christopher S Kovacs; Ad Hermus; Hans de Boer Journal: J Pediatr Endocrinol Metab Date: 2009-08 Impact factor: 1.634
Authors: John P Bilezikian; Maria Luisa Brandi; Richard Eastell; Shonni J Silverberg; Robert Udelsman; Claudio Marcocci; John T Potts Journal: J Clin Endocrinol Metab Date: 2014-08-27 Impact factor: 5.958