Endocrine Abstracts

Managing parathyroid disorders in pregnant women requires careful consideration of the physiological changes in bone and mineral metabolism that occur during pregnancy. Diagnostic and therapeutic approaches for primary hyperparathyroidism (PHPT) and hypoparathyroidism differ significantly from those for non-pregnant patients. For PHPT, it is recommended to perform parathyroidectomy prior to pregnancy whenever possible, as maternal and fetal complications related to hypercalcemia tend to increase with the severity of hypercalcemia. If surgery is necessary during pregnancy, the second trimester is the preferred timing. Mild cases of PHPT are typically managed conservatively, primarily through hydration, though there is limited evidence to support drug treatments in this context. Women with hypoparathyroidism can be reassured that the condition does not typically impair fertility and carries a low risk of pregnancy complications if adequately managed. Regular monitoring is essential, as calcium and active vitamin D requirements may fluctuate during pregnancy, though they generally trend toward reduced dosages. Postpartum and lactation periods require close surveillance for women with parathyroid disorders, as they face an increased risk of hypercalcemia after delivery. Additionally, newborns of mothers with parathyroid conditions should have their calcium levels monitored closely in the days or weeks following birth. Intrauterine exposure to hyper- or hypocalcemia may affect their ability to regulate calcium metabolism postnatally.