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Benign Thyroid Disease
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Thyroid disease in pregnancy is associated with adverse outcomes; therefore, a euthyroid state is required throughout pregnancy to limit developmental risk to the fetus. High levels of HCG in pregnancy can cause a transient hyperthyroidism by stimulating TSH receptors.
The twentieth century
Published in Michael J. O’Dowd, The History of Medications for Women, 2020
Thyroid disease was said to affect approximately 1.5% of the female population, spanning all age groups. Niswander, Gordon and Berends (1972) estimated the prevalence of thyroid disease in pregnancy to be in the order of 0.7%, with spontaneous (or iatrogenic) hypothyroidism occurring four to five times more commonly than hyperthyroidism. As untreated thyroid disease is now rarely encountered in obstetric practice, the following observations by Howard Kelly and Alfred Beck provide an interesting background to the subject.
Hypothyroidism
Published in David S. Cooper, Jennifer A. Sipos, Medical Management of Thyroid Disease, 2018
Case finding, which means testing patients with suggestive symptoms or who are at increased risk for the development of hypothyroidism (presence of a goiter, personal history of autoimmune disease, positive family history of autoimmune thyroid disease) is, in contrast to screening, widely recommended to be done at the discretion of the on-site provider (45–47). Recommendations for thyroid testing in pregnancy are covered elsewhere in this book (see Chapter 12, "Thyroid Disease and Pregnancy").
Current status and challenges in establishing reference intervals based on real-world data
Published in Critical Reviews in Clinical Laboratory Sciences, 2023
Sijia Ma, Juntong Yu, Xiaosong Qin, Jianhua Liu
Women experience their own characteristic physiological changes during and after pregnancy. The first trimester in particular is an important period for predicting pregnancy complications or adverse pregnancy outcomes, and it is important to closely monitor every indicator during this period [89]. The majority of current RIs have been established based on non-pregnant healthy women as reference individuals, and whether they are suitable for use in pregnant women needs to be evaluated [90]. For example, RIs of thyroid function indicators during pregnancy have attracted much attention from scholars worldwide [91–93]. According to large epidemiological studies, thyroid disorders in pregnancy are associated with severe maternal, fetal, and neonatal complications. Therefore, it is crucial to accurately diagnose thyroid disease in pregnancy at an early stage, which implies the need to ensure the availability of precise RIs for thyroid function indicators specific to pregnant women.
Frequency and outcomes of maternal thyroid function abnormalities in early pregnancy
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2019
For outcomes of pregnancy, we observed that maternal hypothyroidism and hyperthyroidism were risk factors for epilepsy, autism spectrum disorders (ASD) and attention deficit hyperactivity disorders (ADHD) [33,34]. An increased risk was particularly observed when the mother was first diagnosed and treated for thyroid disease in the years following the pregnancy, but not when maternal thyroid disease was known at the time of pregnancy and had been treated. The findings supported a hypothesis of fetal programming by maternal thyroid disease [10] and raised a concern about undiagnosed and untreated maternal thyroid disease in pregnancy. However, only indirect measures of exposure were available from the registers and an actual measurement of maternal thyroid function in pregnancy was warranted to extend the hypothesis.
The role of levothyroxine in obstetric practice
Published in Annals of Medicine, 2018
The aim to achieve optimal pregnancy outcomes has lately generated a growing interest in the thyroid screening in pregnancy [9], which consequently highlights the importance of reliable diagnostic criteria and indications for treatment [10]. In this regard, the concurrence of clinical guidelines from different scientific societies [11–13] has contributed to an increasing controversy about the need to detect and treat thyroid dysfunction in pregnancy. More recently, the American Thyroid Association (ATA) has published new guidelines [14] for the diagnosis and management of thyroid disease during pregnancy and the postpartum, which updates evidence-based recommendations taking into account the newest scientific advances in this field, although these guidelines did not form an opinion regarding universal thyroid screening.