Primary hyperparathyroidism in pregnancy : case report and review

Abstract

A twenty-six year old secundagravida booked her pregnancy at 14 weeks gestation. It was noted in the past obstetric history that the woman had lost her first child at 41 weeks gestation, delivering a stillborn baby weighing 4.2kg. At 34 weeks into the second pregnancy mild polyhydramnios was noted and the patient was admitted. During her hospitalisation the patient complained of having passed a small renal stone. Two serum calcium levels were found to be significantly elevated 3.36mmol/l and 3.2mmol/l. Serum parathormone was found to be significantly elevated - 247pg/ml (Normal levels: 12.0 - 72.0pg/ml) and an ultrasound scan of the neck confirmed the presence of a parathyroid adenoma. A parathyroidectomy was performed and the postoperative period was uneventful. The rest of the pregnancy was uneventful and at 38 weeks gestation a healthy child was delivered vaginally. In view of this woman’s past history and the events occurring during the second pregnancy it may be useful to consider obtaining serum levels of calcium in cases of idiopathic stillbirth.