[Disorders of calcium metabolism during pregnancy and breast feeding]

Abstract

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.