Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
Home Print this page Email this page
Users Online: 255

Year : 2008  |  Volume : 5  |  Issue : 1  |  Page : 6-10

Thyroid disease and pregnancy

Endocrine unit, Vivekananda Institute of Medical Sciences, Kolkata

Correspondence Address:
A Mazumdar
Endocrine unit, Vivekananda Institute of Medical Sciences, Kolkata

Login to access the Email id

Source of Support: None, Conflict of Interest: None

Rights and PermissionsRights and Permissions

Thyroid disease is common in younger women and may be a factor in reproductive dysfunction. Once adequately treated this disorder is associated with successful pregnancy outcome. The key is to recognize and to treat thyroid disorders in the reproductive-age woman before conception. Pregnancy is a euthyroid state that is normally maintained by complex changes in thyroid physiology. The fetal hypothalamic-pituitary-thyroid system develops independently and the process is generally complete by the 12 th week of intrauterine life. Early pregnancy is characterized by an increase in maternal T4 secretion stimulated by hCG and an increase in TBG, resulting in elevated total serum T4 in pregnancy. Maternal T4 is important in fetal brain development. There is evidence in human subjects that substantial maternal T4 can cross the placenta during pregnancy, and this is particularly important when there is fetal thyroid agenesis. Maternal and fetal/ neonatal outcomes in pregnancy are adversely affected if severe hypothyroidism is undiagnosed or inadequately treated. Thyroid function tests should be obtained during gestation in women taking thyroxine and appropriate dose adjustments should be made for Free T4 and TSH levels outside the normal range. TSH-receptor blocking antibodies from the mother are a recognized cause of congenital hypothyroidism in the fetus and neonate that can be permanent or transient. Pathophysiologic conditions of hCG secretion such as gestational trophoblastic disease and hyperemesis gravidarum may present as thyrotoxicosis in the first trimester of pregnancy. However the main cause of hyperthyroidism in pregnancy is Graves ' disease. The mainstay of treatment is antithyroid drugs and either propylthiouracil or methimazole may be used safely. Subtotal thyroidectomy, after medical control, is the alternative treatment, but radioiodine ablation is contraindicated. Postpartum thyroiditis can present with transient hyperthyroidism which subsequently evolves into hypothyroidism.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded337    
    Comments [Add]    

Recommend this journal