Management of hypocalcaemia during pregnancy and breastfeeding

In pregnant and breastfeeding women with pre-existing hypoparathyroidism, test serum ionised calcium concentration and serum total calcium concentration corrected for albumin regularly, aiming to maintain the concentrations at the lower limit of the normal range.

During pregnancy, calcitriol and calcium requirements do not usually change appreciably, but if titration is required, adjust the calcitriol dose rather than the calcium dose.

During breastfeeding, bone resorption and reabsorption of calcium from the kidneys increases, so the calcitriol dose requirement usually decreases.