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Thyroid Disease in Pre- and Post-Pregnancy

  • Dev A. Kevat
  • Lucy MackillopEmail author
Chapter

Abstract

Thyroid dysfunction affects approximately 3% of pregnant women. Adequate thyroid hormone levels are important for fetal development. Normal physiological changes of pregnancy can contribute to subclinical hypothyroidism which may require treatment with thyroxine during pregnancy. Pre-existing hypothyroidism requires an increase in thyroxine dosage. Pre-existing hyperthyroidism may or may not require continued treatment with anti-thyroid medication, though these medications can rarely cause adverse fetal effects. Gestational hyperthyroidism must be distinguished from a new diagnosis of Graves’ disease in pregnancy. Gestational hyperthyroidism does not require treatment with anti-thyroid medication. Graves’ disease requires additional monitoring of mother and fetus and consideration of anti-thyroid medication. Post-partum thyroiditis is an underdiagnosed condition which can cause transient hyperthyroidism before recovery or hypothyroidism, or hypothyroidism without a hyperthyroid phase. Serial monitoring of thyroid function test is required. The vast majority of women with thyroid conditions can be managed to a successful pregnancy outcome.

Keywords

Pregnancy Thyroid disease Prenatal care Postnatal care Perinatal care 

Abbreviations

bHCG

Beta human chorionic gonadotropin

IQ

Intelligence Quotient is an attempt to measure intelligence

T3

Free triiodothyronine

T4

Free thyroxine

TRAb

Thyroid receptor antibody levels

TSH

Thyroid stimulating hormone

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Key Reading

  1. 1.
    Alexander EK, Pearce EN, Brent GA. Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum. Thyroid. 2017;27(3):315–89.  https://doi.org/10.1089/thy.2016.0457.CrossRefGoogle Scholar
  2. 2.
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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Monash Health and Western HealthMelbourneAustralia
  2. 2.Department of EndocrinologyWestern HealthSt AlbansAustralia
  3. 3.Oxford University Hospitals NHS Foundation Trust and Nuffield Department of Women’s and Reproductive Health, University of Oxford, Level 6, Women’s Centre, John Radcliffe HospitalOxfordUK

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