Treatment
The National Institutes of Health suggests parathyroidectomy for asymptomatic nonpregnant patients with calcium elevations >1 mg/dL above the upper limits of normal (or >11.5 mg/dL).
Calcium levels vary in the pregnant patient due to the physiological changes that occur.
Carella and Gossain stated that calcium concentrations >10.1 mg/dL during the second or third trimester should prompt an evaluation of PHP.
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.