Jurczyńska Jolanta, Zieleniewski Wojciech, Kunert-Radek Jolanta
Klinika Endokrynologii Instytutu Endokrynologii Uniwersytetu Medycznego, Lodzi.
Ginekol Pol. 2005 Mar;76(3):240-4.
Hypoparathyroidism following thyroidectomy or due to autoimmune process is the most common cause of hypocalcaemia. If untreated, maternal hypocalcaemia may stimulate fetal parathyroids which results in bone demineralization. Calcium supplementation may also reduce the risk of hypertension. Moreover, hypocalcaemia may inhibit the synthesis of calcium gene-related peptide (CGRP), which, in turn, decreases blood pressure and uterus contractions. In women of reproductive age hypercalcaemia is mostly due to hyperparathyroidism. The complications include toxemia, vomiting, and hypercalcaemic crisis. Maternal hypercalcaemia can suppress fetal parathyroid function and cause neonatal hypocalcaemia. The pharmacotherapy involves diuretics, fluids and oral phosphates. Bisphosphonates are contraindicated. Parathyroid surgery may be performed in the second trimester of pregnancy.
甲状腺切除术后或自身免疫性疾病导致的甲状旁腺功能减退是低钙血症最常见的原因。如果不进行治疗，母体低钙血症可能刺激胎儿甲状旁腺，导致骨质脱矿。补充钙也可能降低高血压风险。此外，低钙血症可能抑制钙基因相关肽（CGRP）的合成，进而降低血压和子宫收缩。在育龄女性中，高钙血症主要由甲状旁腺功能亢进引起。并发症包括毒血症、呕吐和高钙血症危象。母体高钙血症可抑制胎儿甲状旁腺功能并导致新生儿低钙血症。药物治疗包括利尿剂、补液和口服磷酸盐。双膦酸盐禁用。甲状旁腺手术可在妊娠中期进行。
