Primary hyperparathyroidism and pregnancy

OBJECTIVE: The coexistence of primary hyper-parathyroidism and pregnancy is very rare worldwide. It carries serious complications to the mother and fetus, therefore, early diagnosis and management is of paramount importance.

METHODS: Over a period of 16 years from 1982-1997, 24 patients with primary hyperparathyroidism were identified from the central diagnostic index data base of King Khalid University Hospital. Out of these, only 3 women with primary hyperparathyroidism complicating pregnancy were identified.

RESULTS: All 3 women were in the fourth decade. Two of them had coexisting vitamin D deficiency with initially normal serum calcium and were misdiagnosed as cases of osteomalacia while the third had very high serum calcium on first presentation. A single parathyroid adenoma was identified in all 3 patients with 2 undergoing surgical removal of the adenoma. The third patient unfortunately had an abortion. The babies of the first 2 patients were born healthy with no complications.

CONCLUSION: Primary hyperparathyridism, even though rare in pregnancy, carries risks to the mother and fetus and therefore early screening for asymptomatic hyper-parathyroidism in all women of childbearing age and in the early antenatal period of pregnant women is recommended.