Hypocalcemia after thyroidectomy and parathyroidectomy in a pregnant woman

Hypoparathyroidism during pregnancy is a very rare endocrine disorder. The majority of cases are postsurgical (75%). Managing pregnant or nursing women with hypoparathyroidism is challenging due to complications arising from either under- or overtreatment, including premature delivery or fetal death, abortion, stillbirth, perinatal death and neonatal tetany. Specific adaptations are needed within each time period to meet the fetal, neonatal and maternal calcium requirements. A systematic search was performed on PubMed using the search terms “pregnancy” and “hypoparathyroidism”. Included were articles published in English between 1 January 1966 and 1 January 2018. We provide an overview of all published cases (n=43) of hypoparathyroidism in pregnancy, including a case report of a 29-year-old pregnant woman who underwent a total thyroidectomy before her current pregnancy because of a therapy-resistant Graves’ disease. The procedure was complicated by postsurgical hypoparathyroidism. She carried out the pregnancy to term with minor complaints of paresthesia and muscle cramps. Furthermore we discuss treatment, complications and follow-up of hypoparathyroidism in pregnancy. Treatment of hypoparathyroidism in pregnancy should still be individualized, depending on the patient’s complaints and serum levels of calcium, which should be maintained in the lower normal range of 2.15-2.55 mmol/l according to literature. We recommend monitoring calcium levels every three to four weeks throughout pregnancy, within one week postpartum and monthly during lactation to ensure normocalcemia.

Jaar van publicatie:2020

Trefwoorden:A1 Journal article

BOF-keylabel:ja

Toegankelijkheid:Open