Complications and Management of Primary Hyperparathyroidism During Pregnancy

Calcium metabolism undergoes physiologic alterations in normal pregnancy, which can potentially lead to confusion and difficulty in the diagnosis of primary hyperparathyroidism occurring during gestation. This does not mitigate the fact that primary hyperparathyroidism can lead to increased morbidity for the mother and fetus, including the life-threatening complication of acute pancreatitis. A high level of suspicion should be maintained if hypercalcemia is detected, and management should be carefully individualized to minimize maternal and fetal complications. Surgery in the second trimester appears to be a safe and viable form of definitive therapy. A team effort from clinicians of different disciplines is the best approach. In this review, we summarize the occurrence, manifestations, and possible treatment options of primary hyperparathyroidism and resultant hypercalcemia during pregnancy by presenting a brief illustrative clinical case and searching the relevant medical literature from 1966 to the present.