Table_1_Parathyroid adenoma in pregnancy: A case report and systematic review of the literature.docx

ObjectivePrimary hyperparathyroidism is a common disorder of the parathyroid glands. Parathyroid adenoma (PA) in pregnancy is a relatively rare disease, whose diagnosis and treatment is a challenging task. The aim of the present study is to present a new case of parathyroid adenoma during pregnancy and to give a detailed account of all reported cases of parathyroid adenoma during pregnancy in the literature.
Study designA bibliographic research was performed, and characteristics of parathyroid adenomas in pregnancy such as age, gestational week at diagnosis, ionized calcium levels, genetic testing result, symptomatology, radiological method of localization, treatment method, gestational week at operation, and maternal/fetal complications were recorded.
ResultsA 34-year-old woman at her 25 weeks’ gestation was diagnosed with parathyroid adenoma and was referred to our Surgical Department due to contraindication for conservative treatment. A parathyroidectomy was performed, and the maternal and fetal postoperative period was uneventful. Two hundred eleven cases of parathyroid adenoma in pregnancy were recorded in the literature, and statistical analysis was performed. The median gestational week at diagnosis was 21 ± 9.61 weeks. The mean level of ionized calcium was 2.69 mmol/l [SD = 0.75 (2.55–2.84 95% CI)]. Most cases were familiar (72.4%), while surgery was the preferred treatment option (67.3%). The majority of cases were asymptomatic (21.7%), and the main radiological method applied for localization was ultrasound (63.4%).
ConclusionParathyroid adenoma in pregnancy is a rare condition. The early diagnosis is of great importance as surgical treatment at the second trimester of pregnancy outweighs the maternal and fetal risks.

研究目标：原发性甲状旁腺功能亢进症（primary hyperparathyroidism）是一类常见的甲状旁腺疾病。妊娠期甲状旁腺腺瘤（parathyroid adenoma, PA）属于相对罕见的病症，其诊断与治疗均极具挑战性。本研究旨在报告1例妊娠期甲状旁腺腺瘤新病例，并系统梳理文献中所有已报道的妊娠期甲状旁腺腺瘤病例。
研究设计：本研究通过文献检索开展，对妊娠期甲状旁腺腺瘤的多项临床特征进行记录，包括患者年龄、确诊时孕周、血清游离钙水平、基因检测结果、临床症状、定位影像学检查方法、治疗方案、手术孕周以及母婴并发症情况。
研究结果：本次研究纳入1例34岁妊娠25周的患者，该患者确诊为甲状旁腺腺瘤，因保守治疗存在禁忌证，被转诊至我院外科。随后为患者实施甲状旁腺切除术，术后母婴恢复情况均平稳。本研究共纳入文献报道的211例妊娠期甲状旁腺腺瘤病例并进行统计学分析：确诊时的孕周中位数为21±9.61周；血清游离钙平均水平为2.69 mmol/L [标准差SD=0.75，95%置信区间CI为2.55~2.84]；其中72.4%的病例为家族性病例，67.3%的患者首选手术治疗；21.7%的病例无明显临床症状，定位检查最常用的影像学方法为超声检查（占比63.4%）。
结论：妊娠期甲状旁腺腺瘤属于罕见病症。早期诊断至关重要，因为在妊娠中期实施手术治疗的母婴风险均处于可控范围。