Calcium Carbonate Intoxication in Pregnancy: The Return of the Milk-Alkali Syndrome

      A 29-year-old primigravid woman was transferred to our unit at 31 weeks’ gestation for consideration of emergency Caesarean section in view of worsening hypertension and unexplained “fetal distress.” She suffered from gastroesophageal reflux disease (GERD) for which she took a proton-pump inhibitor (PPI) prior to pregnancy. Once pregnant, she stopped the PPI in favour of an over-the-counter antacid comprising calcium carbonate (CC) and sucrose. To alleviate her symptoms, our patient required 3000 to 3600  mg of elemental calcium daily, the recommended daily allowance being 1000 mg.
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