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Thyroid test and pregnancy

Peter N Taylor, Stamatios Zouras, Thinzar Min, Kalyani Nagarahaj, John H Lazarus, Onyebuchi Okosieme
Universal thyroid screening in pregnancy is a key debate in thyroidology and obstetrics. It is well-established that thyroid hormones are essential for maintaining pregnancy and optimal fetal development. Thyroid dysfunction is common in women of child-bearing age and also results in substantial adverse obstetric and child neurodevelopmental outcomes. Furthermore, thyroid dysfunction is readily diagnosed with reliable blood tests and easily corrected with inexpensive and available treatments. Screening only high-risk patients appears to miss the majority of cases and economic models show that compared to high-risk screening, universal screening is cost effective even if only overt hypothyroidism was assumed to have adverse obstetric effects...
2018: Frontiers in Endocrinology
R Shah, S V Brodsky, L Hebert, B H Rovin, T Nadasdy, A A Satoskar
Antiphospholipid antibody syndrome (APS) is an acquired prothrombotic autoimmune disease caused by the presence of antibodies against anionic phospholipids or plasma proteins bound to phospholipids on cell membranes. It can be a primary disease or secondary to other autoimmune diseases, most commonly systemic lupus erythematosus (SLE). Laboratory testing for antiphospholipid antibodies (aPL) may be only transiently positive, so APS could be missed until a catastrophic thrombotic episode or pregnancy morbidity occurs...
November 7, 2018: Lupus
Lijin Ji, Na Yi, Qi Zhang, Shuo Zhang, Xiaoxia Liu, Hongli Shi, Bin Lu
Objective To assess the current management of prolactinoma among endocrinologists in China. Methods An online survey of a large sample of endocrinologists was conducted in China. The questionnaire included 21 questions related to controversial issues about the management of prolactinomas. Doctors in the endocrinology department of a university-affiliated hospital or a comprehensive secondary hospital in 12 cities from East, West, South, North and Middle China were surveyed. Results A total of 290 valid questionnaires were collected, and the response rate was 40%...
October 1, 2018: Endocrine Connections
Diana Alecsandru, Ana Barrio, Victor Andia, Edgar Cruz, Pilar Aparicio, Jose Serna, Maria Cruz, Antonio Pellicer, Juan Antonio Garcia-Velasco
Pancreatic Autoimmunity is defined as the presence of autoantibodies and more frequent need for insulin treatment. Affected women presenting recurrent implantation failure (RIF) or recurrent miscarriage (RM) are often misdiagnosed. The objective of thestudy was to describe clinical and metabolic profiles suggestive of Pancreatic Autoimmunity and therapeutic strategy in patients with RIF/RM. We analyzed retrospectively 735 patients, and have identified a subset (N = 20) with similar metabolic characteristics...
2018: PloS One
Mehwish Gilani, Naveed Asif, Ammad Akram, Mehreen Gilani, Aamir Ijaz, Saima Shakil Malik
OBJECTIVE: To determine the reference values for thyroid stimulating hormone, free tetra-iodothyronine and total tri-iodothyronine for healthy pregnant women. METHODS: This cross sectional study was conducted at the Armed Forces Institute of Pathology, Rawalpindi, Pakistan, from January 2016 to June 2017. Pregnant women with normal, single intrauterine, uncomplicated pregnancy were recruited from the local population. Blood sample was taken to analyse thyroid stimulating hormone, free tetra-iodothyronine and total tri-iodothyronine using chemiluminescence immunoassay...
October 2018: JPMA. the Journal of the Pakistan Medical Association
Young Ah Lee, Sun Wook Cho, Ho Kyung Sung, Kyungsik Kim, Young Shin Song, Sin Je Moon, Jung Won Oh, Dal Lae Ju, Sooyeon Choi, Sang Hoon Song, Gi Jeong Cheon, Young Joo Park, Choong Ho Shin, Sue K Park, Jong Kwan Jun, June Key Chung
BACKGROUND: Iodine is an intrinsic element of thyroid hormone, which is essential for childhood growth and development. The Ideal Breast Milk (IBM) cohort study aims to evaluate the effects of maternal iodine status during pregnancy and lactation on maternal thyroid function, offspring growth and development, and offspring thyroid function. METHODS: The IBM cohort study recruited pregnant women from Seoul National University Hospital between June 2016 and August 2017, followed by enrollment of their offspring after delivery...
September 2018: Endocrinology and Metabolism
K M van Veggel, J M Rondeel, S Anten
BACKGROUND: Thyroid function tests may show the combination of a normal concentration of serum thyroidstimulating hormone (TSH) and an increased or decreased level of free thyroxine (free T4). How often this occurs is unclear and not everyone is familiar with how it should be adressed. METHODS: We conducted a retrospective cohort study of all adult patients who presented at a non-academic general hospital in the Netherlands between 1 January 2010 and 31 December 2014 and yielded an increased or decreased free T4 in combination with a normal TSH...
September 2018: Netherlands Journal of Medicine
Shui Boon Soh, Tar Choon Aw
Thyroid disorders are common, affecting more than 10% of people in the US, and laboratory tests are integral in the management of these conditions. The repertoire of thyroid tests includes blood tests for thyroid-stimulating hormone (TSH), free thyroxine, free triiodothyronine, thyroglobulin (Tg), thyroglobulin antibodies (Tg-Ab), thyroid peroxidase antibodies (TPO-Ab), TSH receptor antibodies (TRAb), and calcitonin. TSH and free thyroid hormone tests are frequently used to assess the functional status of the thyroid...
January 2019: Annals of Laboratory Medicine
Xiaotong Gao, Yongze Li, Jiashu Li, Aihua Liu, Wei Sun, Weiping Teng, Zhongyan Shan
Background: Serum thyroid-stimulating hormone (TSH) and free thyroxine (FT4) change dynamically during pregnancy. Differences in geographic regions, populations, and manufacturer's methodologies can affect the reference intervals for thyroid function tests. The 2017 guidelines of the American Thyroid Association (ATA) recommended 4.0 mU/L as the cut-off point for the upper limit of serum TSH in early pregnancy. A systematic review is called for to establish practical, gestational-specific TSH and FT4 reference intervals for pregnant Chinese women and to explore whether the criteria are suitable for China...
2018: Frontiers in Endocrinology
Ying Hong Li, Anthony Marren
BACKGROUND: Recurrent pregnancy loss (RPL) is defined as two or more pregnancy losses. It affects <5% of couples. There are many proposed causes; however, in a significant proportion of cases, the cause is unknown. OBJECTIVE: The aim of this paper is to provide a summary of the aetiology, investigations and management of RPL, which is based on the three most recent international guidelines on RPL (European Society of Human Reproduction and Embryology, 2017; American Society for Reproductive Medicine, 2012; and the Royal College of Obstetricians and Gynaecologists, 2011)...
July 2018: Australian journal of general practice
D Isiklar Ozberk, R Kutlu, I Kilinc, A O Kilicaslan
PURPOSE: To investigate whether mandatory use of iodized salt in Turkey, since 1999 has sufficient effects on pregnant women and their newborns' urinary iodine concentrations (UIC), maternal and newborns' thyroid function tests and breast milk iodine concentrations (BMIC). METHODS: This cross-sectional analytical-type study was conducted in an obstetrics and gynecology hospital in Konya, Turkey. One hundred and seven pregnant women and their 107 full-term newborns were included into the study...
August 11, 2018: Journal of Endocrinological Investigation
Shirley Cueva, Channing Burks, Dana McQueen, Marla S Barkoff, Mary D Stephenson
OBJECTIVE: To determine whether an association exists between maternal antithyroid antibodies and euploid miscarriage in women with recurrent early pregnancy loss (REPL). DESIGN: Observational cohort study. SETTING: Two academic medical centers. PATIENT(S): Women seen between 2004-2015 with a history of REPL, who were euthyroid or had subclinical hypothyroidism, had maternal antithyroid antibody testing and had at least one subsequent early pregnancy loss (<10 weeks' gestation)...
August 2018: Fertility and Sterility
Emi Hamajima, Masahiro Noda, Emina Nai, Satoka Akiyama, Yoji Ikuta, Natsuko Obana, Takahiro Kawaguchi, Kenta Hayashi, Kunihiro Oba, Tomohiro Yoshida, Tatsuo Katori, Masayuki Kokaji
This case report describes a male neonate with Graves' disease. The mother's pregnancy was complicated by poorly controlled Graves' disease. The neonate was diagnosed with thyroxine (T3)-predominant Graves' disease with low free triiodothyronine (T4) and high free T3 during antithyroid drug therapy. The patient also presented with persistent pulmonary hypertension of the newborn due to hyperthyroidism and airway stenosis caused by goiter. It was difficult to control thyroid function and maintain free T4 levels with inorganic iodine, thiamazole, and levothyroxine sodium hydrate...
2018: Clinical Pediatric Endocrinology: Case Reports and Clinical Investigations: Official Journal of the Japanese Society for Pediatric Endocrinology
Elizabeth A Gibson, Eva Laura Siegel, Folake Eniola, Julie Beth Herbstman, Pam Factor-Litvak
Polybrominated Diphenyl Ether (PBDE) flame retardants are environmental chemicals that cross the placenta during pregnancy and have shown evidence of neurotoxicity. As the in utero period is a sensitive developmental window, such exposure may result in adverse childhood outcomes. Associations between in utero PBDE exposure and neurodevelopment are found in animal models and increasingly in human population studies. Here, we review the epidemiological evidence of the association between prenatal exposure to PBDEs and motor, cognitive, and behavioral development in infants and children...
August 2, 2018: International Journal of Environmental Research and Public Health
Svetlana Vujović, Miomira Ivovic, Milina Tančić-Gajić, Ljiljana Marina, Aleksandar Ljubic, Svetlana Dragojević-Dikić, Andrea Ricardo Genazzani
More empathized approach is required and is obligatory to women with premature ovarian insufficiency (POI) interested for pregnancy. In order to improve fertility rate in POI patients our suggestions would be: (1) To decrease FSH value to 10-15 IU/L by increasing estrogen. Oocyte donation can be suggested after a minimum of six month interval from FSH between 10-15 IU/L and when no dominant follicles are found. (2) To perform oral glucose tolerance test (OGTT). Insulin sensitizing agents has to be included, when indicated, 3-6 month before pregnancy...
July 25, 2018: Gynecological Endocrinology
Aly Bernard Khalil, Bashir Taha Salih, Onismos Chinengo, Ma Remy D Bardies, Andrew Turner, Laila O Abdel Wareth
Background: The American Thyroid Association (ATA) recommended the establishment of population specific reference ranges for thyroid hormones during pregnancy. Initial studies conducted in the United Arab Emirates (UAE) in 2003 and 2004 on pregnant women published a considerably higher upper limit for thyroid stimulating hormone (TSH) than that proposed by ATA. The UAE was classified as a country with mild iodine deficiency at the time of this initial study. After the implementation of aggressive strategies to address iodine deficiency over the last decade, the UAE was recently declared as iodine sufficient...
November 2018: Practical Laboratory Medicine
Karolina E Kryczka, Zofia Dzielińska, Maria Franaszczyk, Izabela Wojtkowska, Jan Henzel, Mateusz Śpiewak, Janina Stępińska, Zofia T Bilińska, Rafał Płoski, Marcin Demkow
BACKGROUND Peripartum cardiomyopathy (PPCM) is a potentially life-threatening, pregnancy-associated cause of heart failure affecting previously healthy women. Recent research suggests a possible role of 16-kDa prolactin in promoting cardiomyocyte damage. However, the genetic predisposition is not well recognized. CASE REPORT We report the case of a 25-year-old woman with a severe course of PPCM with left ventricle ejection fraction of 25-30%, complicated by ventricular arrhythmia and postpartum thyroiditis...
July 12, 2018: American Journal of Case Reports
Hongyan Lu, Yuhui Huang, Huang Xin, Cuifang Hao, Yanguo Cui
The aim of this work was to study the expression of the cytokines IFN-γ, IL-4, IL-17 A, and TGF-β1 in peripheral blood and follicular fluid (FF) of patients positive for antithyroid autoantibodies (ATA+ ) with normal thyroid gland function and the influence of these autoantibodies on in vitro fertilization and embryo transfer (IVF-ET) pregnancy outcomes. Nineteen patients were in the ATA+ group, and 27 patients tested negative for anti-thyroid autoantibody (ATA- ). Blood samples were drawn from the two groups of patients on the oocyte retrieval day and the 5th and 14th days of transplantation; in addition, FF was extracted on the oocyte retrieval day from both groups of patients and tested through enzyme-linked immunosorbent assay (ELISA) for IFN-γ, IL-4, IL-17 A, and TGF-β1...
July 11, 2018: Gynecological Endocrinology
Yunbo Zhang, Wanying Zhang, Xihang Fu, Fenfen Zhou, Haiyang Yu, Xiaolin Na
The objectives of this study were to evaluate the effect of maternal Di-2-ethylhexyl phthalate (DEHP) exposure on male offspring and to explore the mechanism of changes with the metabolic alterations and differential genes. Pregnant female Sprague-Dawley (SD) rats were intragastrically administered with 600 mg/kg body weight of DEHP or corn oil (CON) throughout pregnancy and lactation. The growth of male offspring was investigated until 14 weeks old, the indices of blood were detected, and mechanism was studied using metabonomics and transcriptomics...
September 2018: Environmental Science and Pollution Research International
Corey J Lager, Ronald J Koenig, Richard W Lieberman, Anca M Avram
Background: Malignant struma ovarii is an ovarian teratoma containing at least 50% thyroid tissue which has the potential to metastasize and produce thyroid hormone. Given its rarity, management strategies are not well-established. We report a case of metastatic malignant struma ovarii discovered during pregnancy with lessons for evaluation and management. Case presentation: A 30-year-old woman who was two months pregnant was discovered to have struma ovarii with over half of the struma comprised of papillary thyroid cancer...
2018: Clinical Diabetes and Endocrinology
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