Management of parathyroid disorders in pregnancy and postpartum period

During pregnancy, an average-sized fetus needs 30 g of calcium, 20 g of phosphorus, and 0.8 g of magnesium for the skeletal mineralization and other physiological processes [1, 2]. Maternal physiology adapts itself to meet these mineral and supplementary nutrition needs of the fetus and the newborn during pregnancy and lactation. As a natural consequence of that condition, pregnancy and lactation cause serious changes in the maternal calcium metabolism. Thanks to these activated physiological adaptation mechanisms, calcium and vitamin D needs for the mother do not change during pregnancy and lactation. Most of the calcium in breast milk is provided by increased intestinal absorption and maternal bone resorption. This may lead to a decrease in maternal bone mineral density and an increased risk of fracture in the short term, but not to a negative effect in the long term. Disorders of bone and calcium metabolism are rare in pregnant women, but they may progress more severely when they occur. In such a case, the current process should be evaluated and managed bidirectionally for the health of both mother and fetus.