Volume : IX, Issue : VI, June - 2020

Hypoparathyroidism in pregnancy -A review

Dr Pushpalata Dubey, Dr Prakhar Upadhyay, Dr Chandra Mauli Upadhyay

Abstract :

Hypoparathyroidism in pregnancy is rare ,but important because it is associated with maternal morbidity and foetal loss. Hypoparathyroidism leads to hypocalcemia and hyperphosphatemia . Hypocalcemia, defined as low serum levels of albumin–corrected total calcium or of ionized calcium. Hypocalcemia is a total serum calcium concentration < 8.8 mg/dL (< 2.20 mmol/L) in the presence of normal plasma protein concentrations or a serum ionized calcium concentration < 4.7 mg/dL (< 1.17 mmol/L). It has many potential causes. Hypocalcemia results from inadequate parathyroid hormone (PTH) secretion or receptor activation, an insufficient supply of vitamin D or activity of the vitamin D receptor, abnormal magnesium metabolism, or clinical situations in which multiple factors (e.g., pancreatitis, sepsis, and critical illness) and renal diseases play contributing roles. . Hypoparathyroidism results from deficient parathyroid hormone (PTH), which can occur in autoimmune disorders or after the accidental removal of or damage to several parathyroid glands during thyroidectomy. Transient hypoparathyroidism is common after subtotal thyroidectomy, but permanent hypoparathyroidism occurs after < 3% of such thyroidectomies.. Manifestations of hypocalcemia usually begin about 24 to 48 hours postoperatively but may occur after months or years. PTH deficiency is more common after radical thyroidectomy for cancer or as the result of surgery on the parathyroid glands (subtotal or total parathyroidectomy). Risk factors for severe hypocalcemia after subtotal parathyroidectomy include Severe preoperative hypercalcemia, removal of a large adenoma, elevated alkaline phosphatase and Chronic kidney disease. Hypocalcemia can present dramatically as tetany, seizures, altered mental status, refractory congestive heart failure, or stridor. The duration, severity, and rate of development of hypocalcemia determine the clinical presentation. Neuromuscular symptoms are typically the most prominent; these symptoms include muscle cramping, twitching, and spasms; circumoral and acral numbness and paresthesias;laryngospasm; onchospasm; and even seizures. Other complications include premature cataracts, pseudotumor cerei, and calcifications of the basal ganglia. Optimal maintenance of calcium levels during pregnancy is required to minimise the risk of related complications.

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Article: Download PDF    DOI : 10.36106/ijsr  

Cite This Article:

HYPOPARATHYROIDISM IN PREGNANCY -A REVIEW, Dr Pushpalata Dubey, Dr Prakhar Upadhyay, Dr Chandra Mauli Upadhyay INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH : Volume-9 | Issue-6 | June-2020

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