Surgery is the definitive treatment

Surgery is the definitive treatment for PHP. However, since surgery for PHP has inherent potential risks for the pregnant patient, it is often viewed as the last resort.
However, given the increasing evidence that supports a higher morbidity and mortality associated with calcium levels of >11.4 mg/dL, surgical intervention is recommended in patients with levels >11.0 mg/dL, particularly in patients with prior pregnancy loss In a retrospective patient series in the Norman Parathyroid Clinic in Florida, investigators examined pregnant patients with fetal loss and PHP.
They found that patients with calcium levels of 10.7 mg/dL were associated with pregnancy loss, but most pregnancies continued to term.
Calcium levels >11.4 mg/dL were associated with higher levels of fetal loss and 72% of fetal loss occurred at or above this level.