Primary hyperparathyroidism in pregnancy

Objective: To determine the management of a patient with primary hyperparathyroidism and the obstetric and neonatologic outcome. Design: Case report. Setting: University hospital of Udine, Italy. Patient(s): A 32-year-old black pregnant woman with primary hyperparathyroidism. Intervention(s): Hospitalization with observation, nuclear magnetic resonance of the neck, and right parathyroidectomy of the patient in the 15th week of gestation (WG). Monitoring during pregnancy until the delivery. Main Outcome Measure(s): Intrauterine pregnancy preservation and maternal and fetal morbidity and mortality. Result(s): After surgery, laboratory and clinical findings remained constant. The fetus' well-being until the delivery was performed with cardiotocography (CTG) and echographic monitoring. Symmetric intrauterine growth restriction was discovered at 37 WG. Cesarean section was performed at 38 +/- 2 WG owing to the CTG trace. Conclusion(s): Nuclear magnetic resonance of the neck in this case was the determining diagnostic exam. Parathyroidectomy, during the second trimester, is the therapeutic gold standard, especially in cases of severe hypercalcemia (>12 mg/dL).