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Primary hyperparathyroidism in pregnancy after in vitro fertilization

https://doi.org/10.17749/2313-7347/ob.gyn.rep.2024.458

Abstract

Primary hyperparathyroidism (PHPT) in pregnant women is a rare condition, often remaining undiagnosed due to non-specific clinical symptoms. However, it can lead to life-threatening complications for both the mother and fetus. In vitro fertilization (IVF) is also associated with an increased probability of adverse outcomes compared to the general population. Timely diagnostics and personalized treatment, taking into account the extremely high risk of complications if PHPT and pregnancy result from IVF, require attention of healthcare professionals and formation of a multidisciplinary team.

About the Authors

A. S. Bondarenko
State Scientific Center of the Russian Federation, Endocrinology Research Centre
Russian Federation

Axenia S. Bondarenko – MD, Clinical Resident

11 Dmitry Ulyanov Str., Moscow 117292



E. E. Bibik
State Scientific Center of the Russian Federation, Endocrinology Research Centre
Russian Federation

Ekaterina E. Bibik – MD, PhD, Researcher, Endocrinologist, Department of Pathology of the Parathyroid Glands and Mineral Metabolism Disorders

11 Dmitry Ulyanov Str., Moscow 117292



V. V. Voskoboynikov
State Scientific Center of the Russian Federation, Endocrinology Research Centre
Russian Federation

Valeriy V. Voskoboynikov – MD, PhD, Senior Researcher, Surgeon, Surgery Department

11 Dmitry Ulyanov Str., Moscow 117292



O. I. Kolegaeva
National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov, Ministry of Health of the Russian Federation
Russian Federation

Oksana I. Kolegaeva – MD, Endocrinologist, Therapeutic Department

4 Academician Oparin Str., Moscow 117997



A. I. Sazonova
National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov, Ministry of Health of the Russian Federation
Russian Federation

Anna I. Sazonova – MD, PhD, Endocrinologist, Therapeutic Department

4 Academician Oparin Str., Moscow 117997



A. K. Eremkina
State Scientific Center of the Russian Federation, Endocrinology Research Centre
Russian Federation

Anna K. Eremkina – MD, PhD, Researcher, Head of the Department of Pathology of the Parathyroid Glands and Mineral Metabolism Disorders

11 Dmitry Ulyanov Str., Moscow 117292



O. V. Lunyakina
National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov, Ministry of Health of the Russian Federation
Russian Federation

Olga V. Lunyakina – MD, Endocrinologist, Therapeutic Department

4 Academician Oparin Str., Moscow 117997



T. Yu. Ionanidze
National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov, Ministry of Health of the Russian Federation
Russian Federation

Teya Yu. Ionanidze – MD, PhD, Obstetrician-Gynecologist, Junior Research, Obstetric Department of Pregnancy Pathology No. 2

4 Academician Oparin Str., Moscow 117997



A. A. Aksenenko
National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov, Ministry of Health of the Russian Federation
Russian Federation

Artem A. Aksenenko – MD, PhD, Obstetrician-Gynecologist, Gynecology Department No. 1

4 Academician Oparin Str., Moscow 117997



R. M. Esayan
National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov, Ministry of Health of the Russian Federation
Russian Federation

Roza M. Esayan – MD, PhD, Endocrinologist, Head of Therapeutic Department

4 Academician Oparin Str., Moscow 117997



N. K. Tetruashvili
National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov, Ministry of Health of the Russian Federation
Russian Federation

Nana K. Tetruashvili – MD, Dr Sci Med, Professor, Head of the Obstetric Department of Pregnancy Pathology No. 2

4 Academician Oparin Str., Moscow 117997



N. M. Platonova
State Scientific Center of the Russian Federation, Endocrinology Research Centre
Russian Federation

Nadezhda M. Platonova – MD, Dr Sci Med, Head of the Department of Therapeutic Endocrinology

11 Dmitry Ulyanov Str., Moscow 117292



N. G. Mokrysheva
State Scientific Center of the Russian Federation, Endocrinology Research Centre
Russian Federation

Natalia G. Mokrysheva – MD, Dr Sci Med, Professor, Corresponding Member of RAS, Head of the Department of Personalized and Translational Medicine, Director 

11 Dmitry Ulyanov Str., Moscow 117292



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What is already known about this subject?

► Physiological changes that occur in a female body during pregnancy complicate laboratory diagnostics of рrimary hyperparathyroidism (PHPT).

► Being untreated, the incidence of PHPT-related complications in pregnant women, according to various sources, ranges from 14 to 67 %, in newborns – up to 80 %.

► An opportunity of drug therapy for PHPT in pregnant women is limited. The data from recent studies demonstrate the advantage of surgical tactics compared with conservative management in prevention of neonatal complications.

What are the new findings?

► It is advisable to conduct an in-depth examination of women before planning pregnancy and in vitro fertilization (IVF) in case of pathologies associated with impaired phosphorus-calcium metabolism.

► The extremely high risk of complications in PHPT during pregnancy due to IVF requires a special assistance and active interaction between representatives of a multidisciplinary team to chose an optimal treatment tactics aimed at maintaining pregnancy.

How might it impact on clinical practice in the foreseeable future?

► We will propose to introduce a screening assessment of phosphorus-calcium metabolism parameters during preconception period and pregnancy.

Review

For citations:


Bondarenko A.S., Bibik E.E., Voskoboynikov V.V., Kolegaeva O.I., Sazonova A.I., Eremkina A.K., Lunyakina O.V., Ionanidze T.Yu., Aksenenko A.A., Esayan R.M., Tetruashvili N.K., Platonova N.M., Mokrysheva N.G. Primary hyperparathyroidism in pregnancy after in vitro fertilization. Obstetrics, Gynecology and Reproduction. 2024;18(3):414-424. (In Russ.) https://doi.org/10.17749/2313-7347/ob.gyn.rep.2024.458

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ISSN 2313-7347 (Print)
ISSN 2500-3194 (Online)