Primary hyperparathyroidism in pregnancy: a case series and review

Objectives/Hypothesis: To review the clinical significance of primary hyperparathyroidism during pregnancy including the maternal, fetal, and neonatal sequelae. Additionally, to discuss treatment options and describe three cases where surgical parathyroidectomy was successful for treatment of hyperparathyroidism refractory to medical management during pregnancy. Study Design: Retrospective. Methods: We reviewed three cases of hyperparathyroidism during pregnancy and reviewed the literature. Results: Three women underwent surgical parathyroidectomy during their second and third trimester of pregnancy without any maternal, fetal, or neonatal complications. Conclusions: Hyperparathyroidism during pregnancy may be safely treated with surgical parathyroidectomy if refractory to medical management with low operative risk when performed during the second trimester. This surgical option should be considered in light of the known maternal, fetal, and neonatal risks because of the hypercalcemic state in pregnancy.