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Neonatal hypocalcaemia — RACP Paediatrics MCQ

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ModerateEndocrineNeonatal hypocalcaemiaRACP Paediatrics

A neonate born to a mother with untreated hyperparathyroidism develops jitteriness and seizures on day 2. Serum calcium is 1.5 mmol/L. Phosphate is elevated. PTH is low. What is the most appropriate immediate treatment?

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Correct answer: E — IV calcium gluconate 10%

Neonatal hypocalcaemia with seizures requires immediate IV calcium gluconate 10% (0.5 mL/kg slowly over 5-10 minutes with cardiac monitoring). Rapid infusion can cause bradycardia. The cause here is maternal hyperparathyroidism suppressing fetal PTH production (transient hypoparathyroidism). Maintenance oral calcium and calcitriol may be needed.

Reference: RCH Melbourne – 2023 – Neonatal Hypocalcaemia CPG; RACP Paediatric Curriculum – Endocrine