von Poblotzki M, Strauss A, Schulze A, Hepp H
Neonatologie der Klinik und Poliklinik für Geburtshilfe und Frauenheilkunde des Klinikum der Ludwig-Maximilians-Universität München, Grosshadern, Germany.
Gynakol Geburtshilfliche Rundsch. 2003 Jan;43(1):36-8. doi: 10.1159/000067164.
Parathyroidectomy is effective in avoiding complications of primary hyperparathyroidism (pHPT) during pregnancy, because in about 90% of cases, it is caused by parathyroid adenomas. We present a case of severe pHPT during pregnancy of unknown etiology and without detectable parathyroid adenoma so that surgery was not a therapeutic option. The patient was a 29-year-old gravida 1 who presented with pHPT at 11 weeks of gestation. Although her serum calcium levels were elevated throughout pregnancy (>3.05 mmol/l; reference range: 2.05-2.65), a vigorous premature infant was delivered at 35 weeks of gestation. The infant received calcium intravenously, vitamin D(3) orally and was fed with raw human milk (low phosphorus) to prevent hypocalcemia. The baby did not develop clinical signs of hypocalcemia. Her initial parathyroid hormone level was suppressed (1.1 pg/ml; reference range: 15-65) and was normal at the age of 8 weeks. She was discharged from hospital at 14 days of life. Her physical, cognitive and motor development was normal through infancy and early childhood. In conclusion, pHPT during pregnancy does not necessarily lead to fetal or neonatal morbidity or mortality.
甲状旁腺切除术对于避免妊娠期原发性甲状旁腺功能亢进症（pHPT）的并发症是有效的，因为在大约90%的病例中，该病是由甲状旁腺腺瘤引起的。我们报告一例妊娠期间病因不明且未检测到甲状旁腺腺瘤的严重pHPT病例，因此手术并非治疗选择。患者为一名29岁初产妇，在妊娠11周时出现pHPT。尽管她在整个孕期血清钙水平均升高（>3.05 mmol/L；参考范围：2.05 - 2.65），但在妊娠35周时分娩出一名健康的早产儿。婴儿静脉输注钙剂、口服维生素D(3)，并喂以人初乳（低磷）以预防低钙血症。婴儿未出现低钙血症的临床症状。其最初的甲状旁腺激素水平被抑制（1.1 pg/ml；参考范围：15 - 65），在8周龄时恢复正常。她在出生后14天出院。在婴儿期和幼儿期，其身体、认知和运动发育均正常。总之，妊娠期pHPT不一定会导致胎儿或新生儿发病或死亡。
