Disorders of calcium metabolism and parathyroid disease

Pregnancy and lactation are associated with profound changes in calcium physiology. This can make interpretation of biochemical tests difficult during these times. Diseases of bone and calcium metabolism are uncommon during pregnancy but can be severe when they occur. These conditions are complicated by the need for dual consideration for the maternal and foetal health. These conditions are also much less well studied than related conditions that occur outside of pregnancy resulting in a reduction in evidence for and confidence in recommendations relating to management. This chapter will review the changes in calcium physiology that occur with pregnancy and lactation, describe the disorders of calcium and parathyroid physiology that can occur and outline the most appropriate way to manage these conditions.