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Hypercalcemia in a calcitriol-treated hypoparathyroid woman during lactation

Article Abstract:

Hypoparathyroidism (diminished levels of parathyroid hormone) causes abnormalities of calcium metabolism, and may be treated with preparations that contain vitamin D, which promotes absorption of calcium. The effect of two of these preparations (calcitriol and dihydrotachysterol) on three pregnant, hypoparathyroid women, are discussed in a case report. The women were treated during a total of five pregnancies. Either calcitriol or dihydrotachysterol was taken during pregnancy and the postnatal period, while blood levels of calcium were monitored. One of the women continued to experience increasing calcium levels (hypercalcemia), even during breast-feeding, which resolved when the drug was discontinued. In general, calcium absorption increases during the latter stages of pregnancy, as does the need for drugs that contain vitamin D in hypoparathyroid women. In these cases, the increased requirement for vitamin D was noted beginning at 20 to 28 weeks of gestation. During breast-feeding, the dose of calcitriol should be reduced. Overall, it appears that calcitriol is an effective agent for use in pregnant, hypoparathyroid women. A discussion is provided of the physiological effects of vitamin D-containing drugs on pregnant women who are also hypoparathyroid. (Consumer Summary produced by Reliance Medical Information, Inc.)

Author: Caplan, Robert H., Beguin, Everett A.
Publisher: Elsevier B.V.
Publication Name: Obstetrics and Gynecology
Subject: Health
ISSN: 0029-7844
Year: 1990
Physiological aspects, Drug therapy, Lactation, Hypoparathyroidism

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Late diagnosis of nonconjoined monoamniotic twins using computed tomographic imaging: a case report

Article Abstract:

Monoamniotic twins (those who share a single amniotic sac, the membranous sac in which the fetuses float) are at high risk for death in the perinatal period. The condition is very rare, with only 0.1 to 2.3 percent of all twin pregnancies being monoamniotic twins. Fifty percent of these fetuses die, but early detection of this condition can lead to better outcomes. Computerized tomographic (CT) imaging, a technique that provides highly detailed views of the body's soft tissues, may be effective for visualizing the fetuses after injection of a dye to outline the amniotic sac. The case history is presented of a 23-year-old woman examined in this manner when she was 34 weeks pregnant. The presence of a single amniotic sac was confirmed, and after tests that showed that the fetal lungs were sufficiently mature, a cesarean section was performed. Both babies were in good health and went home with the mother eight days later. The report shows the value of a single CT view at the correct anatomical plane in revealing monoamniotic twins. (Consumer Summary produced by Reliance Medical Information, Inc.)

Author: Angel, Jeffrey L., Carlan, Stephen J., Sawai, Shirley K., Vaughn, Vickie
Publisher: Elsevier B.V.
Publication Name: Obstetrics and Gynecology
Subject: Health
ISSN: 0029-7844
Year: 1990
Abnormalities, Complications and side effects, Twins, Amniotic sac, Amnion

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Subjects list: Case studies, Pregnancy, Complications of, Pregnancy complications
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