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Management of hypothyroidism in pregnancy ppt: ACOG Update: Thyroid Disease in Pregnancy

Aliya Roohi.

Subclinical hypothyroidism also needs to be detected and treated to prevent adverse outcomes, especially maternal. Be the mqnagement to comment Login to see the comments. A recent case report described a patient who had subclinical hypothyroidism prior to IVF that was adequately treated with LT4. This lack of continuous effect raises questions about the week finding. Radionuclide scintigraphy or radioiodine uptake determination should not be performed in pregnancy.

  • All Alerts Posts. One observational study analyzing women at 12, 24, and 32 weeks of pregnancy demonstrated delayed infant neurodevelopment in women with persistent hypothyroxinemia.

  • Show More. When levothyroxine dosage achieves equilibrium, resume monitoring TSH alone

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  • On Slideshare 0. How to Treat Hypothyroidism Naturally - The most common condition related to the thyroid is hypothyroidism.

  • It was and is especially effective as a preparation for subsequent thyroid surgery, as introduced by Plummer in Based on findings extrapolated from investigations of treated hypothyroid women from early pregnancy onwardsit is reasonable to evaluate these women for TSH elevation approximately every 4 weeks during pregnancy.

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From embeds 0. Pregnany every young woman, eager to have children and to complete her family life, she too was full of joy and anticipation. Women who had previously been diagnosed with hypothyroidism, abnormal TSH and FT4 levelsbut who do not have symptoms. S and S of the disorder, goiter.

Hypothyroidism During pregnancy. Check out PowerShow. Like Liked. Views Total views. Total views 6, Download with free trial. Recommend initiating levothyroxine therapy in women with antithyroid antibodies before pregnancy, if TSH level is greater than 2.

Home Explore Login Signup. Start on. Subclinical hypothyroidism: asymptomatic patient. Pregnant women: a.

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For these reasons thyroid function is frequently assessed during the gestation period. Patients using either desiccated thyroid or a treatment regimen combining T3 and T4 are likely at risk for having insufficient transfer of maternal T4 to the fetal brain. Interestingly, many large-scale studies demonstrate that the populations of women with elevated TSH concentrations are generally exclusive from those identified with low FT4 concentrations.

Importantly, only FT4 is available for tissue jn, with the remainder of T4 bound management of hypothyroidism in pregnancy ppt serum proteins, primarily TBG. Isolated hypothyroxinemia is typically defined as a FT4 concentration in the lower 2. No notes for slide. Thyroid stimulating antibodies, ATDs, and most maternal thyroid hormones can effectively cross the placenta barrier. However, no neurodevelopmental outcomes were associated with maternal or infant TPOAb status. The combination of LT4 and an ATD block-replace therapy has in general been shown not to improve GD remission ratesand it results in a larger dose of ATD required in order to maintain the FT4 within the target range. Since that publication, additional much larger cohorts have published center-specific and trimester-specific pregnancy reference ranges.

This is further discussed in the ATA guidelines for the management of fo In an iodine-deficient area iodized salt intake before pregnancy did improve maternal thyroid function; no difference in child neurodevelopment was noted 54but improvement has been noted in other studies Groups with an increased likelihood of thyroid dysfunction Previous thyroid disease or surgery Goitre. Cholestyramine is not absorbed from the gut and thus not transferred to the fetus and may moderately reduce circulating thyroid hormones by binding the hormones during their enterohepatic circulation — When possible, population-based trimester-specific reference ranges for serum TSH should be defined through assessment of local population data representative of a health care provider's practice.

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Non pregnant: 1. WordPress Shortcode. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Home Explore Login Signup.

Start on. Full Name Comment goes here. Uncontrolled hypothyroidism. Full Name Comment goes here. It's FREE! American Thyroid Association : 1.

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Upcoming SlideShare. No Downloads. Benha University Hospital, Egypt E-mail:elnashar53 hotmail. We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. Effects of hypothyroidism on pregnancy The impact of maternal hypothyroidism on the fetus depends on the severity of the condition.

  • Neurodevelopmental consequences of maternal hypothyroidism during pregnancy abstract 88;annual Meeting of the American Thyroid Association Thyroid.

  • On Slideshare 0. Recommend initiating levothyroxine therapy in women with antithyroid antibodies before pregnancy, if TSH level is greater than 2.

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For newly management of hypothyroidism in pregnancy ppt hypothyroid women, initial levothyroxine dosage is based pregnancu severity of hypothyroidism. Thyroid Disease During Pregnancy - The thyroid is a large gland located in the neck that is responsible for hormone growth and regulation, which means that any thyroid disorder can throw a lot of things in your body out of whack. If you continue browsing the site, you agree to the use of cookies on this website. Annirene Kiome. From embeds 0.

Full Name Comment goes here. Maternal T4 crosses the placenta actively, the only hormone that does so. Download with free trial. On Slideshare 0. Show related SlideShares at end. See our Privacy Policy and User Agreement for details.

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American Thyroid Association : 1. Downloads Congenital cretinism: Growth failure, mental retardation, and other neuropsychologic deficits including deaf-mutism.

Physiological changes of thyroid during pregnancy 1. You just clipped your first slide! Incidence Much more common in women than men Common in those with family history Overt hypothyroidism: 0. It might be Hypothyroidism, a very common phrase we hear these days affecting people in an enormous way.

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Non pregnant: 1. Downloads Congenital cretinism: Growth failure, mental retardation, and other neuropsychologic deficits including deaf-mutism. Actions Shares. Total views 10,

Because of increased thyroid hormone production, increased renal iodine excretion, and fetal iodine requirements, dietary iodine requirements are higher in pregnancy than they are for nonpregnant adults A reduction in the lower TSH reference range is observed during pregnancy in almost all studies. However, Poppe et al. The healthy thyroid adapts to these alterations through changes in thyroid hormone metabolism, iodine uptake, and the regulation of the hypothalamic-pituitary-thyroid axis 34. Dosage augmentation should occur as soon as possible when a missed menstruation or suspected pregnancy occurs, and this should be discussed with every patient in the prepregnancy setting.

These concentrations then remain high until delivery. Home Explore Login Signup. In Shanghai, China, iodine deficiency was noted in a subset of pregnant women 72whereas in Shenyang city management of hypothyroidism in pregnancy ppt iodine excess was noted, with a consequent increase in subclinical hypothyroidism This variation can in part be explained by some studies pooling overt and subclinical hypothyroid cases together, while others used different TSH cutoff values, and yet others enrolled a very limited number of subjects The description of supporting evidence is different for diagnostic accuracy studies. Prevalence of thyroid deficiency in pregnant women.

No Downloads. WordPress Shortcode. Comments 0. Maternal T4 crosses the placenta actively, the only hormone that does so.

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Management of hypothyroidism in pregnancy ppt is a greater likelihood that dose increases will be required in those patients without functional thyroid tissue e. Some women in whom Hypothgroidism is initiated during pregnancy may not require LT4 post partum. Iodized salt remains the mainstay of iodine deficiency disorder elimination efforts worldwide. The thyroid function tests of healthy pregnant women, therefore, differ from those of healthy nonpregnant women. What remains uncertain is the nuanced understanding of how this risk is reduced or abated as the extent of maternal hypothyroidism is normalized or other variables are modified. Thyrotoxic women should be rendered stably euthyroid before attempting pregnancy. Miscarriage Anaemia Intrauterine fetal demise and stillbirth preterm delivery, low birth weight, preeclampsia, developmental anomalies including reduced IQ.

Actions Shares. Infertility is defined as the failure to achieve a clinical pregnancy after 12 or more months of regular unprotected sexual intercourse Whereas it is customary for manufacturers to suggest that pregnancu establish their own reference range for such a test, this suggestion is frequently impractical for FT4 assessment because it is especially difficult to recruit subjects with specific conditions such as pregnancy from which to independently establish method- and trimester-specific reference ranges. The largest decrease in serum TSH is observed during the first trimester because of elevated levels of serum hCG directly stimulating the TSH receptor and thereby increasing thyroid hormone production Table 4. Women with adequate iodine intake before and during pregnancy have adequate intrathyroidal iodine stores and have no difficulty adapting to the increased demand for thyroid hormone during gestation. Women with a free T4 below the 2. Cancel Download.

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However, when FT4 concentrations increased during pregnancy, infant development was not improved Clinical studies have confirmed that the increased requirement for thyroxine or exogenous LT4 occurs as early as 4—6 weeks of pregnancy Cases of iodine-induced congenital hypothyroidism have been reported in children of U.

Effects on maternal thyroid function have been mixed, with significant maternal TSH decreases with supplementation described in four 88909195 of the eight published trials, jypothyroidism increases in maternal T4 or FT4 noted in just two 90 Children born to untreated hypothyroid women had an IQ score that was 7 points below the mean IQ of children born to healthy women and women given thyroxine supplements. Some studies evaluating nonpregnant women have shown that selenium can diminish TPOAb concentrations — In such cases. The prevalence may be higher in areas of iodine insufficiency. Clin Endocrinol Oxf ; 50

Embed Size px. Antithyroids :no role. The pattern of changes in serum concentrations of thyroid function studies and hCG according to gestational age. Chandravikram Singh. Annirene Kiome. Congenital cretinism: Growth failure, mental retardation, and other neuropsychologic deficits including deaf-mutism.

A study by Negro et al. Corresponding Author: Dr. A meta-analysis of eight studies that included Ab-positive patients and controls noted a significant association between thyroid Ab positivity and recurrent pregnancy loss OR 2. Why not share! Disclaimer Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development.

  • However, this limit can only be used after week 16 of pregnancy.

  • Occasionally, pregnancy may cause symptoms similar to hyperthyroidism in the first trimester. See our Privacy Policy and User Agreement for details.

  • Prior to initiating the reviews, all task force members were provided written and verbal group advice on conducting electronic literature searches, critical appraisal of articles, and rationale for formulating strength of recommendations. If measured in pregnant women, assay method-specific and trimester-specific pregnancy reference ranges should be applied.

  • The most notable change is the increase in thyroxine-binding globulin TBG.

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Based on a single small randomized clinical trial and one retrospective cohort, LT4 treatment for thyroid Ab-positive managejent without thyroid dysfunction undergoing IVF does not appear to improve outcomes Examples include infection, trauma, cervical insufficiency, premature rupture of membranes, and maternal medical conditions. A downward shift of the TSH reference range occurs during pregnancy, with a reduction in both the lower decreased by about 0. To use this website, you must agree to our Privacy Policyincluding cookie policy. If you continue browsing the site, you agree to the use of cookies on this website. From embeds 0. Published by Bertina Adams Modified over 6 years ago.

Hashimotos thyroiditis Comments 0. From embeds 0. Thyroid Gland - Investigation of primary hypothyroidism Why not share! Clipping is a handy way to collect important slides you want to go back to later. American Thyroid Association : 1.

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Start on. Successfully reported this slideshow. Total views 6, The following upper-normal reference ranges are recommended: 1st T: 2. You can change your ad preferences anytime.

Hypothyroidism During pregnancy 1. The fetal CNS is relatively impermeable to T3, which therefore argues against use of exogenous T3 during pregnancy. A special cause of thyrotoxicosis is overtreatment with or factitious intake of thyroid hormone. In some studies,[ 18 ] infants and toddlers whose mothers had reduced serum free T4 concentrations with normal TSH during gestation 12 to 20 weeks had lower mean intelligence, psychomotor, or behavioral scores compared with children born to women with normal thyroid function during gestation.

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Presentation on theme: "THYROID DISORDERS & PREGNANCY"— Presentation transcript:

Another study by Negro et management of hypothyroidism in pregnancy ppt. Source of Support: Managemet. Similarly, this study demonstrated no significant effect of treatment on offspring IQ at the age of 5 years Together with pituitary TSH, placental hCG stimulates endogenous thyroid hormone production when an intact thyroid is present, and it helps to maintain a euthyroid state during gestation. Thyroid antibody positivity separately increases the risk of thyroid dysfunction following delivery and during the postpartum period.

We can help you find more about effective and reliable natural hypothyroidism treatment. Likes If one experiences palpitations, weight loss, and persistent vomiting, one should contact their doctor immediately. The pattern of changes in serum concentrations of thyroid function studies and hCG according to gestational age. Clipping is a handy way to collect important slides you want to go back to later. Number of embeds 4. Be the first to comment Login to see the comments.

WordPress Shortcode. Show More. They are all artistically enhanced with visually stunning color, shadow and lighting effects. Our new CrystalGraphics Chart and Diagram Slides for PowerPoint is a collection of over impressively designed data-driven chart and editable diagram s guaranteed to impress any audience.

Overt Hypothyroidism Subclinical Hypothyroidism No. Views Total views. Universal screening of heathy women for thyroiddysfunction is not recommendedhigh risk individuals for thyroid illnessshould be screened with prenatal TSHUniversal screening for the presence of anti TPOanibodies is not recommended Medical Disorders of Pregnancy

  • Allied with regular post-partum follow up, is required to ensure favourable maternal and fetal outcomes.

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  • Iodized salt remains the mainstay of iodine deficiency disorder elimination efforts worldwide.

  • Thyrotoxic women should be rendered stably euthyroid before attempting pregnancy.

Successfully reported this slideshow. Title: Hypothyroidism in Pregnancy. Insufficient evidence to recommend universalscreening for thyroid disease in pregnant women They are all artistically enhanced with visually stunning color, shadow and lighting effects.

  • The organization of management guideline recommendations is shown in Table 3.

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  • Lithium has thyroid-inhibiting effects somewhat similar to pharmacological doses of iodinebut it may be teratogenic and therefore should not be used to treat hyperthyroidism in pregnancy.

  • Common Medical Complications in Pregnancy - Inciting event e. If you continue browsing the site, you agree to the use of cookies on this website.

  • For previously diagnosed hypothyroid women, monitor serum TSH every 3—4 weeks during first half of pregnancy and every 6 weeks thereafter.

If one experiences palpitations, weight loss, and persistent vomiting, one should contact their doctor immediately. Visibility Others can see my Clipboard. Full Name Comment goes here. You can change your ad preferences anytime. Actions Shares.

Universal screening, compared with case finding did not result in a decrease in adverse outcomes. Children born to untreated hypothyroid women had an IQ score that was 7 points below the mean IQ of children born to healthy women and women given thyroxine supplements. Antithyroid antibodies have been associated with perinatal death in some but not allstudies. Given the prevalence and potential dangers detailed above, many have suggested universally evaluating thyroid function in all women either before or during pregnancy. Following a precipitous drop in urinary iodine values between andU. As noted above, FT4 measurement performed by indirect analog immunoassays is used by the majority of clinical laboratories, largely because of its ability to be quickly performed on automated platforms.

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Table 3. The guidelines were then management of hypothyroidism in pregnancy ppt to the ATA membership for review and comments over a 2-week period. In particular, a serum TSH below 0. Results: The revised guidelines for the management of thyroid disease in pregnancy include recommendations regarding the interpretation of thyroid function tests in pregnancy, iodine nutrition, thyroid autoantibodies and pregnancy complications, thyroid considerations in infertile women, hypothyroidism in pregnancy, thyrotoxicosis in pregnancy, thyroid nodules and cancer in pregnant women, fetal and neonatal considerations, thyroid disease and lactation, screening for thyroid dysfunction in pregnancy, and directions for future research. Free hormone levels are estimated, as total hormone levels are elevated due to changes in TBG levels.

Hypothyroidism During pregnancy. Title: Hypothyroidism in Pregnancy. Download with free trial. Related More from user.

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Maintain the TSH concentration at 2. Home Management of hypothyroidism in pregnancy ppt Login Signup. Incidence Much more common manafement women than men Common in those with family history Overt hypothyroidism: 0. The pattern of changes in serum concentrations of thyroid function studies and hCG according to gestational age. If you continue browsing the site, you agree to the use of cookies on this website. Start on. See our User Agreement and Privacy Policy.

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Should subclinical hypothyroidismbe treated in pregnancy? Total views 14, Do you have PowerPoint slides to share? Hypothyroidism During pregnancy 1. Hypothyroidism - When you feel fatigue and it seems as if you are less energetic then it is high time to get your Thyroid checked. Are you sure you want to Yes No. Visibility Others can see my Clipboard.

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Benha University Hospital, Egypt E-mail:elnashar53 hotmail. Comments 0. If you continue browsing the site, you agree to the use of cookies on this website. Monitor serum TSH and total T4 levels 3—4 weeks after every dosage adjustment. Home Explore Login Signup. Why not share!

  • Two major screening strategies have evolved: i initial blood T4 assay, with follow-up TSH assay if the blood T4 value is below a certain cut-off usually less than the 10 th percentile ; ii an initial blood TSH assay. Home Explore Login Signup.

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  • Hypothyroidism is widely prevalent in pregnant mannagement and the rate of detection, especially in a developing country like India, has not kept pace with the magnitude of the problem. As both medications are associated with potential adverse effects and shifting potentially may lead to a period of less-tight control, no recommendation regarding switching antithyroid drug medication can be made at this time.

  • Most cases present with marked elevations of serum hCG

Reinblatt managemenh al. Therefore, at present, there are insufficient data from which to draw any conclusion regarding the utility of LT4 administration for the purpose of reducing preterm delivery. In women who are TPOAb positive, both overt and subclinical hypothyroidism may occur because of a lack of ability of the thyroid to augment production when needed during pregnancy. Women consuming levothyroxine LT4 regularly do not require supplemental iodine because the substrate is no longer needed for hormone formation. In some cases, hospitalization is required. Multiple studies have dwelt upon the risk of miscarriage in patients with autoimmune thyroid disease. However, the recent spate of reports highlighting the advantages of universal screening and the propensity of targeted case finding to miss a sizeable number of cases, seem to give universal screening a definite edge over targeted case finding.

These analyses combine data from over 60, subjects 1724— When possible, population-based trimester-specific reference ranges for serum TSH should be defined through assessment of local population ppregnancy representative of a health care provider's practice. Overt maternal hypothyroidism has consistently been shown to be associated with an increased risk of adverse pregnancy complications as well as detrimental effects upon fetal neurocognitive development Similar presentations. Shekar Medichelimala. Hypothyroid :may require treatment and some significant rate of residual hypothyroidism Recommend: maintain thyroxine until childbearing is complete, with an attempt to wean off medication 1 year after the last delivery Second, a subset of young patients with severe GD may not become stably euthyroid within the first year after I therapy, ,

Password Trouble? Insufficient evidence exists to recommend for or against treating euthyroid pregnant women who are thyroid autoantibody positive with LT4 to prevent preterm delivery. There is a greater likelihood that dose increases will be required in those patients without functional thyroid tissue e. This shows that these factors may be important confounders in various studies and underlines the importance of performing in-depth analyses of observed associations.

  • In a cross-sectional study of women with infertility, the prevalence of TSH elevations was 2.

  • Hypothyroidism During pregnancy 1.

  • In particular, a serum TSH below 0.

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You can change your ad preferences anytime. Commercially baked breads have been pot major source of iodine in the United States because of the use of iodate bread conditioners For these reasons, the task force feels that any T3-containing preparation should be avoided for the treatment of maternal hypothyroidism during pregnancy. As described in Section Vsome studies suggest that TPOAb-positive euthyroid women may be at increased risk for adverse clinical outcomes not observed in TPOAb-negative comparators If measured in pregnant women, assay method-specific and trimester-specific pregnancy reference ranges should be applied. The prevalence of antibodies varies with ethnicity. Subclinical hypothyroidism also needs to be detected and treated to prevent adverse outcomes, especially maternal.

Non pregnant: 1. Show related SlideShares at end. Cancel Save. Miscarriage Anaemia Intrauterine fetal demise and stillbirth preterm delivery, low birth weight, preeclampsia, developmental anomalies including reduced IQ. Most of the presentations and slideshows on PowerShow. Visibility Others can see my Clipboard. Predisposition to metabolic diseases i.

From embeds 0. This is especially true if you have a thyroid disease, such as hyperthyroidism or hypothyroidism, when pregnant. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising.

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  • In some cases, hospitalization is required.

  • However, all three studies had serious design flaws including small sample sizes, heterogeneous patient populations, lack of or limited randomization, and differences in the timing of treatment initiation.

  • Therefore, laboratories customarily adopt the pregnancy ranges provided by the test manufacturers.

However, overt hyperthyroidism and hypothyroidism warrant further management. A large plasma manaement and thus an altered distribution of thyroid hormone increased thyroid hormone metabolism, increased renal clearance of iodide, higher levels of hepatic production of thyroxine-binding globulin TBG in the hyperestrogenic state. If the address matches an existing account you will receive an email with instructions to reset your password. Peripartum Cardiomyopathy: Definitions, Diagnosis and Management. Download with free trial.

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Aboubakr Elnashar. World's Best PowerPoint Templates - CrystalGraphics offers more PowerPoint templates than anyone else in the world, with over 4 million to choose from. Tags: hypothyroidism pregnancy. The following upper-normal reference ranges are recommended: 1st T: 2.

  • One approach to reducing this variability is to use the Multiple of Medians calculation to compare values between assays. In general, serum T3 tends to be disproportionately elevated more than T4 in cases of thyrotoxicosis caused by direct thyroid hyperactivity.

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  • Cases of iodine-induced congenital hypothyroidism have been reported in children of U.

  • Thyroid antibody positivity separately increases the risk of thyroid dysfunction following delivery and during the postpartum period.

In comparison, T4 tends to be disproportionately elevated beyond T3 when thyrotoxicosis is caused by destructive processes such as thyroiditis Impaired psychomotor development at 10 months in infants born to mothers who had low T4 during the first 12 ws of gestation Pop et al, 2. The prevalence of overt hypothyroidism in pregnancy is estimated to be between 0. However, only a small number of studies have investigated the impact of LT4 treatment on pregnancy complications in such women. Oral administration of iodized oil can increase birth weight in addition to correcting iodine deficiency

Overt Hypothyroidism Subclinical Hypothyroidism No. Download with free trial. Pot Liked. We'll even convert your presentations and slide shows into the universal Flash format with all their original multimedia glory, including animation, 2D and 3D transition effects, embedded music or other audio, or even video embedded in slides. Hypothyroidism During pregnancy. View by Category Toggle navigation.

Thank youInstitute of Medicine Report, November Now customize the name of a clipboard to store your clips. Subclinical hypothyroidism: asymptomatic patient.

  • The risk of rapid relapse of hyperthyroidism after medication withdrawal in early pregnancy varies among patients.

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  • Congenital cretinism: Growth failure, mental retardation, and other neuropsychologic deficits including deaf-mutism.

  • Hypothyroid :may require treatment and some significant rate of residual hypothyroidism Recommend: maintain thyroxine until childbearing is complete, with an attempt to wean off medication 1 year after the last delivery In nonpregnant women with mild TSH elevations following controlled ovarian stimulation, serum TSH measurements should be repeated in 2—4 weeks because levels may normalize.

  • Women with adequate iodine intake before and during pregnancy have adequate intrathyroidal iodine stores and have no difficulty adapting to the increased demand for thyroid hormone during gestation. No adverse association between thyroid function and perinatal mortality was noted.

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Complex interactions between the D2 and D3 iodothyronine deiodinases during gestation help to fine tune the supply of adequate amounts of T3 required for normal brain development. The pregnancy ppt number of hours awarded for this Continuing Nursing Education activity is 0. Sera of pregnant women are characterized by higher concentrations of TBG and nonesterified fatty acids and by lower concentrations of albumin relative to the sera of nonpregnant women. There is a greater likelihood that dose increases will be required in those patients without functional thyroid tissue e. Maternal iodine supplementation in severely iodine-deficient areas also decreases rates of stillbirth and neonatal and infant mortality 90 ,

The hyperthyroid phase of postpartum thyroiditis, is treated with a beta-adrenergic antagonist drugs. The ongoing TABLET study in the United Kingdom, a randomized clinical trial examining effects of LT4 treatment of euthyroid women with a history of infertility or recurrent pregnancy loss, will examine preterm birth as a secondary outcome. The WHO recommends that pregnant and lactating women have an iodine intake of mg per day, which is mg above that recommended for nonpregnant adults, to compensate for increased thyroxine requirements, renal iodine losses, and fetal iodine requirements in pregnancy. The authors found an increasing risk of pregnancy complications pregnancy loss, preterm delivery, and placental abruption in relation to maternal subclinical hypothyroidism during early pregnancy, although subclinical hypothyroidism was variably defined across studies Medications may be a source of excessive iodine intake for some individuals. Although MMI and PTU both appear in human milk, it is at very small concentrations The decision whether to breastfeed while taking antithyroid agents is an individual decision that should be discussed by the patient and her physician. The task force recognizes the limited availability of trimester-specific reference ranges calculated for most ethnic and racial populations with adequate iodine intake who are free of thyroid autoantibodies.

Management of hypothyroidism in pregnancy ppt multiple studies have shown that subclinical hypothyroidism is associated with an adverse outcome for the mother and offspring, most guideline s recommend thyroxine replacement in women with subclinical hypothyroidism. Although a clear association has been demonstrated between thyroid antibodies and spontaneous pregnancy loss, it does not prove causality and the underlying mechanisms for such an association remain unclear. A special cause of thyrotoxicosis is overtreatment with or factitious intake of thyroid hormone. The decision to discontinue LT4, if desired, should be made by the patient and their caregiver.

  • In one cohort study, increases in serum TSH during ovarian stimulation were more marked in LT4-treated women than in women without underlying hypothyroidism 1 week after hCG administration.

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  • In such cases. However, in a cross-sectional study, the prevalence of hyperthyroidism both subclinical and overt was similar in infertile women compared to fertile controls

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Subclinical hypothyroidism and pregnancy outcomes. Thus, no conclusion can be drawn from these data. Ostensibly, this study does not seem to be in favour of universal hypothyroidism, but a closer examination reveals otherwise. In addition, some dietary supplements such as kelp and some iodine preparations may contain very large amounts of iodine several thousand times higher than the daily upper limit and should not be taken. Therefore, laboratories customarily adopt the pregnancy ranges provided by the test manufacturers. One observational study analyzing women at 12, 24, and 32 weeks of pregnancy demonstrated delayed infant neurodevelopment in women with persistent hypothyroxinemia. Thus, despite imperfect data, the majority of evidence appears to support an association between overt thyroid dysfunction and an increased risk of infertility.

Subclinical hypothyroidism also needs to be detected and treated to prevent adverse outcomes, especially maternal. Pregnancy ppt of thyroxine also depends hypothydoidism the etiology of hypothyroidism with disorders with very little residual tissue, like radioiodine ablation and extensive thyroid surgery requiring a greater increment in thyroxine dosage than women with Hashimoto's thyroiditis, who usually have some residual thyroid tissue. However, if the risk is considered high, medication should not be withdrawn, and PTU should be administered as the drug of choice. Upcoming SlideShare. Trends Endocrinol Metab.

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