title: Concurrent parathyroidectomy and caesarean section in the third trimester.
abstract: BACKGROUND
  Primary hyperparathyroidism is the most common cause of hypercalcemia in the general population. It is a rare complication of pregnancy that is difficult for clinicians to recognize, yet it can have important and devastating effects for both mother and baby.
  
  
  METHODS
  A 27-year-old primigravida at 32+3 weeks' gestation had a serum calcium level in excess of 2.75 mmol/L and evidence of HELLP syndrome. She underwent concurrent parathyroidectomy and Caesarean section. Neither the mother nor the neonate developed hypocalcemia postoperatively. The mother's parathyroid tissue was pathologically atypical, and a left hemithyroidectomy was performed at three months postpartum.
  
  
  CONCLUSIONS
  When hyperparathyroidism is diagnosed in the third trimester, concurrent parathyroidectomy and Caesarean section is a safe and reasonable option for management. This should be performed by a multidisciplinary team with careful monitoring of the calcium levels of both mother and neonate after surgery.
authors.affiliation: Northern Ontario School of Medicine, Sudbury ON.
authors.forename: Christopher
authors.initials: C
authors.lastname: Trebb
authors.affiliation: Northern Ontario School of Medicine, Sudbury ON; Health Sciences North, Sudbury ON.
authors.forename: Sarah
authors.initials: S
authors.lastname: Wallace
authors.affiliation: Northern Ontario School of Medicine, Sudbury ON; Health Sciences North, Sudbury ON.
authors.forename: Fadel
authors.initials: F
authors.lastname: Ishak
authors.affiliation: Northern Ontario School of Medicine, Sudbury ON; Health Sciences North, Sudbury ON.
authors.forename: Karen L
authors.initials: KL
authors.lastname: Splinter
mesh_terms: D000328:Adult; D002585:Cesarean Section; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000601:surgery*; D016105:Parathyroidectomy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery*; D011263:Pregnancy Trimester, Third
keywords: Caesarean delivery; hyperparathyroidism; parathyroid neoplasms; pregnancy; pregnancy complications; third trimester