THYROID AND PARATHYROID SURGERIES DURING PREGNANCY

AUTHORS:
M. Andrasi (Debrecen, Hungary) , R. Fedor (Debrecen, Hungary) , D. Toth (Debrecen, Hungary) , D.A. Kovacs (Debrecen, Hungary) , T. Sotkovszki (Debrecen, Hungary) , T. Deli (Debrecen, Hungary) , A. Erdei (Debrecen, Hungary) , L. Toth (Debrecen, Hungary) , E. Nagy (Debrecen, Hungary) , F. Gyory (Debrecen, Hungary)
Background:
Indications for elective thyroid and parathyroid surgeries during pregnancy are limited. During pregnancy thyroid nodules may grow faster due to altered maternal metabolic processes and hormonal changes, which can lead to compression complaints, tumor progression and exacerbation of hyperthyroidism. Surgical intervention is recommended to perform in the second trimester if possible, to minimize the risk of mother and fetus.
Methods:
Between 2011 and 2022, 5166 thyroid and 436 parathyroid surgeries were performed among which 11 were performed during pregnancy.
Results:
All 11 patients were operated on during the second trimester due to suspected tumors and severe hypercalcemia. In all thyroid cases intraoperative histology was performed. During the two parathyroid excisions intraoperative blood samples for PTH measurement were taken. None of the surgeries led to any complications in the pregnancies, while postoperative hypocalcaemia occurred in two cases. 8 healthy children were born from these pregnancies
Conclusions:
Thyroid or parathyroid surgery during pregnancy requires proper, meticulous preoperative preparations. During the perioperative period, more attention is required from medical colleagues and staff. Close multidisciplinary cooperation between professions is essential for complex and effective treatment of pregnant patients.