PRIMARY HYPERPARATHYROIDISM IN THE 3RD TR IMESTER OF PREGNANCY

History and findings: A 24-year-old pregnant woman had to be hospitali zed in the 33rd week of pregnancy because of premature contractions an d clinical signs of pyelonephritis. She had a history of nephrolithias is. Laboratory tests showed a total calcium of 3.6 mmol/l, hypophospha taemia of 0.59 mmol/l and an increased parathormone level of 420 ng/l. Ultrasonography demonstrated a large parathyroid adenoma, confirming the diagnosis of primary hyperparathyroidism. Course and treatment: De spite several recommendations of conservative treatment in the literat ure it was decided to perform a parathyroidectomy, which was done with out complication during the 35th week of pregnancy. A healthy, mature boy was born at the beginning ot the 41st week: at no time did he show any signs of hypoparathyroidism. Conclusions: Surgical treatment of h yperparathyroidism is a reasonable and possible choice even in the 3rd trimester, because it allows regeneration of the fetal parathyroid. H owever, this decision must be individualized, in relation to the perio d of pregnancy and any progression of the disease.