Hypoparathyroidism in Pregnancy and Lactation: Current Approach to Diagnosis and Management
Background: Hypoparathyroidism is an uncommon endocrine disorder. During pregnancy, multiple changes occur in the calcium-regulating hormones, which may affect the requirements of calcium and active vitamin D during pregnancy in patients with hypoparathyroidism. Close monitoring of serum calcium dur...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/7/1378 |
| _version_ | 1797539654115786752 |
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| author | Dalal S. Ali Karel Dandurand Aliya A. Khan |
| author_facet | Dalal S. Ali Karel Dandurand Aliya A. Khan |
| author_sort | Dalal S. Ali |
| collection | DOAJ |
| description | Background: Hypoparathyroidism is an uncommon endocrine disorder. During pregnancy, multiple changes occur in the calcium-regulating hormones, which may affect the requirements of calcium and active vitamin D during pregnancy in patients with hypoparathyroidism. Close monitoring of serum calcium during pregnancy and lactation is ideal in order to optimize maternal and fetal outcomes. In this review, we describe calcium homeostasis during pregnancy in euparathyroid individuals and also review the diagnosis and management of hypoparathyroidism during pregnancy and lactation. Methods: We searched the MEDLINE, CINAHL, EMBASE, and Google scholar databases from 1 January 1990 to 31 December 2020. Case reports, case series, book chapters, and clinical guidelines were included in this review. Conclusions: During pregnancy, rises in 1,25-dihydroxyvitamin D (1,25-(OH)2-D3) and PTH-related peptide result in suppression of PTH and enhanced calcium absorption from the bowel. In individuals with hypoparathyroidism, the requirements for calcium and active vitamin D may decrease. Close monitoring of serum calcium is advised in women with hypoparathyroidism with adjustment of the doses of calcium and active vitamin D to ensure that serum calcium is maintained in the low-normal to mid-normal reference range. Hyper- and hypocalcemia should be avoided in order to reduce the maternal and fetal complications of hypoparathyroidism during pregnancy and lactation. Standard of care therapy consisting of elemental calcium, active vitamin D, and vitamin D is safe during pregnancy. |
| first_indexed | 2024-03-10T12:48:56Z |
| format | Article |
| id | doaj.art-fcf51ca27f4f4869b189fad04802dcf0 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T12:48:56Z |
| publishDate | 2021-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-fcf51ca27f4f4869b189fad04802dcf02023-11-21T13:16:59ZengMDPI AGJournal of Clinical Medicine2077-03832021-03-01107137810.3390/jcm10071378Hypoparathyroidism in Pregnancy and Lactation: Current Approach to Diagnosis and ManagementDalal S. Ali0Karel Dandurand1Aliya A. Khan2Division of Endocrinology and Metabolism, McMaster University, Hamilton, ON L8S 4L8, CanadaDivision of Endocrinology and Metabolism, McMaster University, Hamilton, ON L8S 4L8, CanadaDivision of Endocrinology and Metabolism, McMaster University, Hamilton, ON L8S 4L8, CanadaBackground: Hypoparathyroidism is an uncommon endocrine disorder. During pregnancy, multiple changes occur in the calcium-regulating hormones, which may affect the requirements of calcium and active vitamin D during pregnancy in patients with hypoparathyroidism. Close monitoring of serum calcium during pregnancy and lactation is ideal in order to optimize maternal and fetal outcomes. In this review, we describe calcium homeostasis during pregnancy in euparathyroid individuals and also review the diagnosis and management of hypoparathyroidism during pregnancy and lactation. Methods: We searched the MEDLINE, CINAHL, EMBASE, and Google scholar databases from 1 January 1990 to 31 December 2020. Case reports, case series, book chapters, and clinical guidelines were included in this review. Conclusions: During pregnancy, rises in 1,25-dihydroxyvitamin D (1,25-(OH)2-D3) and PTH-related peptide result in suppression of PTH and enhanced calcium absorption from the bowel. In individuals with hypoparathyroidism, the requirements for calcium and active vitamin D may decrease. Close monitoring of serum calcium is advised in women with hypoparathyroidism with adjustment of the doses of calcium and active vitamin D to ensure that serum calcium is maintained in the low-normal to mid-normal reference range. Hyper- and hypocalcemia should be avoided in order to reduce the maternal and fetal complications of hypoparathyroidism during pregnancy and lactation. Standard of care therapy consisting of elemental calcium, active vitamin D, and vitamin D is safe during pregnancy.https://www.mdpi.com/2077-0383/10/7/1378hypoparathyroidismpregnancycalcium homeostasislactationPTH/PTHrPcalcitriol |
| spellingShingle | Dalal S. Ali Karel Dandurand Aliya A. Khan Hypoparathyroidism in Pregnancy and Lactation: Current Approach to Diagnosis and Management Journal of Clinical Medicine hypoparathyroidism pregnancy calcium homeostasis lactation PTH/PTHrP calcitriol |
| title | Hypoparathyroidism in Pregnancy and Lactation: Current Approach to Diagnosis and Management |
| title_full | Hypoparathyroidism in Pregnancy and Lactation: Current Approach to Diagnosis and Management |
| title_fullStr | Hypoparathyroidism in Pregnancy and Lactation: Current Approach to Diagnosis and Management |
| title_full_unstemmed | Hypoparathyroidism in Pregnancy and Lactation: Current Approach to Diagnosis and Management |
| title_short | Hypoparathyroidism in Pregnancy and Lactation: Current Approach to Diagnosis and Management |
| title_sort | hypoparathyroidism in pregnancy and lactation current approach to diagnosis and management |
| topic | hypoparathyroidism pregnancy calcium homeostasis lactation PTH/PTHrP calcitriol |
| url | https://www.mdpi.com/2077-0383/10/7/1378 |
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