{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T20:28:14Z","timestamp":1770755294338,"version":"3.50.0"},"reference-count":9,"publisher":"The Endocrine Society","issue":"9","license":[{"start":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:00:00Z","timestamp":1755129600000},"content-version":"vor","delay-in-days":28,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Primary hyperparathyroidism (PHPT) is rare in pregnancy and poses diagnostic challenges due to overlapping symptoms. This case series highlights diagnostic and management challenges in pregnant patients. Case 1: A 42-year-old woman at 33\u2005weeks\u2019 gestation exhibited severe nausea and fatigue. Laboratory testing revealed elevated calcium 13.2\u2005mg\/dL (3.29\u2005mmol\/L) (reference range, 8.4-10.3\u2005mg\/dL [2.2-2.6\u2005mmol\/L]) and parathyroid hormone (PTH) 215\u2005pg\/mL (23.89 nmol\/L) (reference range, 11-68\u2005pg\/mL [SI: 1.6-7.2\u2005pmol\/L]). Neck ultrasound identified bilateral parathyroid adenomas and abdominal ultrasound showed polyhydramnios. Parathyroidectomy resulted in calcium drop to 9.5\u2005mg\/dL (2.27\u2005mmol\/L) and PTH to 12\u2005pg\/mL (1.33\u2005pmol\/L). She delivered a healthy infant. Case 2: A 39-year-old woman at 39\u2005weeks\u2019 underwent a cesarean delivery due to transverse fetal lie. She had high prepartum calcium of 14.2 mg\/dL (3.55\u2005mmol\/L) and PTH 319\u2005pg\/mL (33.81\u2005pmol\/L). Post pregnancy, bilateral neck exploration and left inferior parathyroid excision decreased calcium to 8.9\u2005mg\/dL (2.22\u2005mmol\/L) and PTH to 16.5\u2005pg\/mL (1.75\u2005pmol\/L). These cases highlight that symptom severity\u2014not just calcium level\u2014should guide parathyroidectomy. Third-trimester surgery can be safely performed when symptomatic; asymptomatic patients may be managed expectantly. Early recognition and individualized management optimize maternal and fetal outcomes.<\/jats:p>","DOI":"10.1210\/jcemcr\/luaf177","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T10:05:08Z","timestamp":1752746708000},"source":"Crossref","is-referenced-by-count":0,"title":["Two Cases of Primary Hyperparathyroidism During Pregnancy and Post-Partum"],"prefix":"10.1210","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0568-7554","authenticated-orcid":false,"given":"F N U","family":"Varsha","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Allegheny Health Network , Pittsburgh, PA 15212 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Grimes","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Allegheny Health Network , Pittsburgh, PA 15212 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8907-269X","authenticated-orcid":false,"given":"Gayatri","family":"Jaiswal","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Allegheny Health Network , Pittsburgh, PA 15212 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia","family":"Bononi","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Allegheny Health Network , Pittsburgh, PA 15212 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2025,8,14]]},"reference":[{"issue":"10","key":"2025081404291182200_luaf177-B1","doi-asserted-by":"crossref","first-page":"e1117","DOI":"10.1210\/clinem\/dgad201","article-title":"Stable incidence and increasing prevalence of primary hyperparathyroidism in a population-based study in Scotland","volume":"108","author":"Soto-Pedre","year":"2023","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"2025081404291182200_luaf177-B2","doi-asserted-by":"crossref","first-page":"145","DOI":"10.4103\/aam.aam_61_16","article-title":"Primary hyperparathyroidism in pregnancy","volume":"16","author":"Rchachi","year":"2017","journal-title":"Ann Afr Med"},{"issue":"4","key":"2025081404291182200_luaf177-B3","doi-asserted-by":"crossref","first-page":"83","DOI":"10.14740\/jmc3441","article-title":"Primary hyperparathyroidism in pregnancy: a case report","volume":"11","author":"Zanardini","year":"2020","journal-title":"J Med Cases"},{"issue":"5","key":"2025081404291182200_luaf177-B4","doi-asserted-by":"crossref","first-page":"475","DOI":"10.3390\/biomedicines9050475","article-title":"Parathyroid disease in pregnancy and lactation: a narrative review of the literature","volume":"9","author":"Tsourdi","year":"2021","journal-title":"Biomedicines"},{"issue":"6","key":"2025081404291182200_luaf177-B5","doi-asserted-by":"crossref","first-page":"1505","DOI":"10.1210\/clinem\/dgac734","article-title":"Approach to the patient: management of parathyroid diseases across pregnancy","volume":"108","author":"Appelman-Dijkstra","year":"2023","journal-title":"J Clin Endocrinol Metab"},{"key":"2025081404291182200_luaf177-B6","doi-asserted-by":"crossref","first-page":"975954","DOI":"10.3389\/fendo.2022.975954","article-title":"Parathyroid adenoma in pregnancy: a case report and systematic review of the literature","volume":"13","author":"Pliakos","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"2","key":"2025081404291182200_luaf177-B7","doi-asserted-by":"crossref","first-page":"R33","DOI":"10.1530\/EJE-21-1044","article-title":"European expert consensus on practical management of specific aspects of parathyroid disorders in adults and 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