Data are lacking regarding the use and safety of recombinant human parathyroid hormone 1–84 (rhPTH(1–84)) in pregnancy and breastfeeding. In light of the recent issues affecting rhPTH(1–84) availability for people with hypoparathyroidism, this may remain so for some time.

Here, Liao and Cusano report the case of a woman who acquired hypoparathyroidism following total thyroidectomy at the age of 28. Due to challenges in achieving stable serum calcium levels with calcium and calcitriol supplementation, she began rhPTH(1–84) therapy. Since commencing rhPTH(1–84), she has had two pregnancies during which she continued rhPTH(1–84) in early pregnancy, as well as during breastfeeding.

The authors report the course of both pregnancies, including biochemistry and obstetric outcomes. They also summarise the changes that occur in calcium metabolism during pregnancy, and the current approaches to managing people with hypoparathyroidism in the antenatal and perinatal periods.

Read the full article in Endocrinology, Diabetes & Metabolism Case Reports doi: 10.1530/EDM-22-0401