INTRAUTERINE GROWTH-RETARDATION IN A WOMAN WITH PRIMARY HYPERPARATHYROIDISM - A CASE-REPORT

BACKGROUND: Primary maternal hyperparathyroidism leads to increased se rum calcium levels, which suppress fetal parathyroid development, lead ing to hypocalcemia in the neonate. CASE: In a pregnant woman, hyperca lcemia teas observed to be related to a parathyroid adenoma that was s urgically removed at 15 weeks' gestation. Subsequently, hypocalcemia d eveloped, requiring calcium replacement. There was marked premature ca lcification of the placenta, noted to be grade 3 at 23 weeks, and this was thought to be related to the severe intrauterine growth retardati on that Inter developed. Preterm premature rupture of membranes occurr ed at 33 weeks, and a growth-retarded neonate with a small, calcified placenta teas delivered. CONCLUSION: Pregnancies associated with hyper parathyroidism have been found to be complicated by an increased inci dence of spontaneous abortion, stillbirth and neonatal tetany. There m ay also be an increased risk of fetal intrauterine growth retardation. Serial ultrasonography to evaluate fetal growth and antenatal testing should be considered.