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A Case of Primary Hyperparathyroidism-induced Myoclonic Seizure during the Third Trimester of Pregnancy

Hyun Jin Cho

Primary hyperparathyroidism is very rare during pregnancy, but it may impart significant complications to the mother and fetus. In the second trimester, the treatment of choice is a parathyroidectomy during the pregnancy. However, there is a controversy with regards to surgery during the third trimester. A woman was diagnosed with acute pancreatitis due to hyperparathyroidism at 32 weeks of gestation. Her hypercalcemia was normalized after medical treatment. She was recommended for a surgery. However, she didn’t undergo surgery before delivery. She had a tonicclonic seizure during labor. After a cesarean, the patient underwent a parathyroidectomy, which improved her medical condition. The neonate suffered from neonatal tetany. In this presented case, a refusal to perform this operation might be dangerous for the mother and baby even during the third trimester. Thus, the operative treatment for primary hyperparathyroidism should be considered even in women who are in the third trimester of pregnancy.