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gestational thyroid disease

Sudipa Sarkar, Lindsay A Bischoff
Hyperthyroidism can occur during pregnancy and the postpartum period, and the treatment of hyperthyroidism should be considered in the preconception phase. Pregnancy has multiple normal physiologic effects on thyroid hormone, which is a separate process distinct from syndromes such as transient hyperthyroidism of hyperemesis gravidarum. The rationale regarding antithyroid drug use during different stages of pregnancy is reviewed, including the literature regarding adverse neonatal outcomes such as aplasia cutis and methimazole embryopathy in the setting of first trimester maternal methimazole use...
October 14, 2016: Seminars in Reproductive Medicine
Helen Robinson, Philip Robinson, Michael D'Emden, Kassam Mahomed
BACKGROUND: First-trimester care of maternal thyroid dysfunction has previously been shown to be poor. This study evaluates early management of thyroid dysfunction in pregnancy in Australia. METHODS: Patients reviewed by the Obstetric Medicine team for thyroid dysfunction from 1 January 2012 to 30 June 2013 were included. Data were collected on gestation at referral from the patient's general practitioner to the antenatal clinic, information provided in the referral letter, thyroid function tests and thyroid medications...
September 2016: Obstetric Medicine
Bartosz Hudzik, Barbara Zubelewicz-Szkodzinska
Antithyroid drugs (ATD) are widely used for the treatment of Graves' disease (GD) in the general population. Over the past decade there has been an increasing awareness that several disturbances of thyroid function may occur in mothers after delivery which may be more prevalent than previously appreciated. Exacerbation of immune reactions occurs 3-12 month following delivery. Management of hyperthyroidism during lactation requires special considerations and should be implemented to prevent any adverse outcomes in mother and neonate...
August 26, 2016: Clinical Endocrinology
Robert Krysiak, Karolina Kowalcze, Bogusław Okopień
Thyrotoxicosis is a pathological syndrome in which tissue is exposed to excessive amounts of circulating thyroid hormones. Including its subclinical form, it is considered as one of the most frequent endocrine disorders in the general population. If not detected in a timely fashion, thyrotoxicosis can have serious health consequences. The most common forms of thyrotoxicosis include diffuse toxic goiter (Graves' disease), toxic multinodular goiter (Plummer's disease), and toxic adenoma (Goetsch's disease). The significant progress in the fields of hormonal assessment, imaging procedures and molecular biology made in recent years has brought about great improvement in the identification, differentiation and treatment of many other disorders associated with thyrotoxicosis...
2016: Przegla̧d Lekarski
M Fraenkel, T Shafat, O Erez, Y Lichtenstein, J Awesat, V Novack, A Tsur
We aimed to examine the distribution of 1(st) trimester TSH and evaluate its association with perinatal outcomes and future development of maternal thyrotoxicosis. This retrospective cohort study included data of all women without prior thyroid disease who delivered a singleton at our medical center from 1/2001 to 12/2011 and had a 1(st) trimester TSH<4.0 mU/l. Women were divided according to 1(st) trimester TSH concentrations into quartiles and by predefined TSH values (mU/l): 1) TSH<0.1; 2) TSH 0...
July 2016: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
Lei Zhu, Dora Baczyk, Stephen J Lye, Zhenyu Zhang
OBJECTIVE: To investigate the relationship between placental transthyretin (TTR) level and preeclampsia. MATERIALS AND METHODS: Placental tissues from uncomplicated and preeclamptic pregnancies were analyzed using immunohistochemistry and image analysis. We measured the mean optical density (OD) of immunohistochemical staining of TTR across multiple sections using Image Pro Plus 6.0. To avoid bias, we used placental tissue array, which contained preeclamptic placentas (n=8) and the control placentas (n=6) on the same slide...
June 2016: Taiwanese Journal of Obstetrics & Gynecology
M Xue, Q L Shi, K N Tan, Y Wu, R Zhou
OBJECTIVE: To determine whether color doppler ultrasonography (CDU), thyroid function or thyroid autoimmune antibodies could identify Graves' disease in pregnancy(GDP) in pregnant patients with newly diagnosed thyrotoxicosis. METHODS: It is an observational study. Sixty-eight pregnant patients with newly diagnosed thyrotoxicosis including gestational hyperthyroidism(GHT) subjects (GHT group, n=33) and GDP subjects (GDP group, n=35), and 62 age-and sex-matched healthy subjects (C1 group: pregnant, n=32, C2 group: non-pregnant, n=30) were recruited...
June 2016: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Zhimin Liao, Yaqin Xiong, Linli Luo
A 29-year-old woman at 34 weeks' gestation with uncontrolled hyperthyroidism and thyrotoxic heart disease was admitted to urgency Cesarean section. After preoperative sedation and good communication, low-dose spinal anesthesia (7.5 mg 0.5 % bupivacaine) combined with epidural anesthesia (6 ml 2 % lidocaine) was performed through L3-4 inter-vertebral. Opioids were given intravenously to the mother for sedation after delivery of the baby. Satisfactory anesthesia and sedation was provided during surgery. The mother and the neonate were safe and no special complication was found after surgery...
August 2016: Journal of Anesthesia
H Vitkova, J Jiskra, D Springer, Z Limanova, Z Telicka, J Bartakova, M Trendelenburg, E Potlukova
Anti-C1q antibodies (anti-C1q) have been implicated in the pathogenesis of autoimmune diseases, including autoimmune thyroid disorders (AITD). The aim of this study was to evaluate the association between anti-C1q and thyroid function in pregnancy-associated AITD. In 96 pregnant women screened positive for AITD (thyroid dysfunction and/or antibodies against thyroperoxidase - TPOAb), anti-C1q were measured during the 9-11th gestational week and after delivery (median 16 months after delivery), and compared to the corresponding serum levels of thyroid hormones...
October 2016: Clinical and Experimental Immunology
Luisa Aguiar, Jane Garb, Edward Reiter, Paul Visintainer, Rachana Singh, Holley Allen, Ksenia Tonyushkina
OBJECTIVE: To identify predictors of transience vs permanence of neonatal hyperthyrotropinemia. We hypothesized that infants with greater severity of perinatal stress are more likely to have transient thyrotropin elevations. STUDY DESIGN: We retrospectively studied infants diagnosed with hyperthyrotropinemia between 2002 and 2014, following them for up to 12 years after diagnosis. Patients were divided into 3 groups: transient hyperthyrotropinemia (treatment was never prescribed), transient congenital hypothyroidism (treatment started but discontinued), and permanent congenital hypothyroidism (withdrawal unsuccessful or not attempted)...
July 2016: Journal of Pediatrics
Robin Medhi, Banani Das, Arpana Das, Mansur Ahmed, Sonika Bawri, Suditi Rai
PURPOSE: To analyze the adverse obstetrical and perinatal outcome of adolescent mothers associated with first birth. PATIENTS AND METHODS: This prospective case-control study was conducted in a tertiary care teaching hospital of North-East India between January 2014 and December 2014. All adolescent primigravidae completing 28 weeks of gestation with singleton pregnancy and delivered at our institution were included in the study group. Primigravidae aged between 20 and 25 years were taken as a control group...
2016: Adolescent Health, Medicine and Therapeutics
Sajad Jeddi, Jalal Zaman, Asghar Ghasemi
Aging is associated with increased prevalence of cardiovascular disease. Thyroid hormone deficiency during fetal life decreases myocardial tolerance to ischemia-reperfusion (IR) injury in later life. The long-term effects of fetal hypothyroidism (FH) on response to IR injury in aged rats have not been well documented. The aim of this study was therefore to compare the effect of FH on tolerance to IR injury in young and aged male rats and to determine contribution of iNOS (inducible nitric oxide synthase), Bax, and Bcl-2...
May 1, 2016: Nitric Oxide: Biology and Chemistry
Asma Deeb, Ihab Elkadry, Salima Attia, Hana Al Suwaidi, Laila Obaid, Nadia A Schoenmakers
BACKGROUND: Congenital hypothyroidism (CH) is caused by thyroid gland (TG) dysgenesis or inadequate thyroid hormone biosynthesis in a structurally normal gland. Different etiologies are known to be associated with various clinical, biochemical and imaging markers and a subset of cases have an underlying genetic basis. Despite the presence of neonatal screening programs in the UAE, there is a lack of data on the disease etiology in the area. We aim to study the etiology of CH in our center and examine its relationship with the clinical, biochemical, genetic and radiological features...
July 1, 2016: Journal of Pediatric Endocrinology & Metabolism: JPEM
Zachary Anderson, Eric Larson, Muhammad Khan, Maria Bell
INTRODUCTION: Gestational trophoblastic disease (GTD) encompasses a group of tumors derived from trophoblasts, which normally form the placenta during pregnancy. Human chorionic gonadotropin (hCG) is a glycoprotein composed of an alpha subunit identical to that of thyroid stimulating hormone (TSH), follicle-stimulating hormone (FSH), and luteinizing hormone (LH). Detection of beta-hCG is achievable in both urine and serum samples, proving useful for the detection of normal pregnancy and GTD...
February 2016: South Dakota Medicine: the Journal of the South Dakota State Medical Association
Jean N Cheong, Mary E Wlodek, Karen M Moritz, James S M Cuffe
Babies born small are at an increased risk of developing myriad adult diseases. While growth restriction increases disease risk in all individuals, often a second hit is required to unmask 'programmed' impairments in physiology. Programmed disease outcomes are demonstrated more commonly in male offspring compared with females, with these sex-specific outcomes partly attributed to different placenta-regulated growth strategies of the male and female fetus. Pregnancy is known to be a major risk factor for unmasking a number of conditions and can be considered a 'second hit' for women who were born small...
September 1, 2016: Journal of Physiology
Majed Afana, Waleed Brinjikji, David Kao, Elizabeth Jackson, Thomas M Maddox, David Childers, Kim A Eagle, Melinda B Davis
BACKGROUND: Peripartum cardiomyopathy (PPCM) is associated with advanced maternal age, African-American race, hypertensive disorders of pregnancy, and multiple-gestation pregnancies. Less is known regarding racial differences in risk factors and predictors of adverse in-hospital outcomes. METHODS AND RESULTS: A total of 1,337 women with PPCM were identified with the use of the Nationwide Inpatient Sample (2004-2011). Clinical profiles and maternal outcomes in delivering mothers with and without PPCM were compared and stratified by race...
July 2016: Journal of Cardiac Failure
Pedro Weslley Rosario, Marina Carvalho, Maria Regina Calsolari
OBJECTIVE: To define the normal range of TSH in the first trimester of gestation and to evaluate the correlation between maternal TSH and obstetric and neonatal outcomes. SUBJECTS AND METHODS: Prospective study. Women without known or clinically suspected thyroid disease and without risk factors for thyroid dysfunction, who became pregnant spontaneously and were initially evaluated up to week 12 of gestation, were included. Women with positive anti-thyroperoxidase antibodies, twin pregnancy, hyperemesis gravidarum, and trophoblastic disease were excluded...
August 2016: Archives of Endocrinology and Metabolism
Annemiek M C P Joosen, Ivon J M van der Linden, Neletta de Jong-Aarts, Marieke A A Hermus, Antonius A M Ermens, Monique J M de Groot
BACKGROUND: Trimester-specific reference intervals for TSH are recommended to assess thyroid function during pregnancy due to changes in thyroid physiology. Laboratories should verify reference intervals for their population and assay used. No consistent upper reference limit (URL) for TSH during pregnancy is reported in literature. We investigated the use of non-pregnant reference intervals for TSH, recommended during pregnancy by current Dutch guidelines, by deriving trimester-specific reference intervals in disease-free Dutch pregnant women as these are not available...
July 1, 2016: Clinical Chemistry and Laboratory Medicine: CCLM
Stine Linding Andersen, Jørn Olsen, Peter Laurberg
OBJECTIVE: Thyroid disorders are common in women of reproductive age, but the exact burden of disease before, during and after a pregnancy is not clear. We describe the prevalence of thyroid disease in women enrolled in the Danish National Birth Cohort (DNBC) and investigate some of its risk factors. DESIGN: Population-based study within the DNBC, which included 101,032 pregnancies (1997-2003). METHODS: We studied women enrolled in the DNBC who gave birth to a live-born child...
February 2016: European Journal of Endocrinology
Jinfu Zhou, Jinying Luo, Hong Zhao, Jing Wang, Feng Lin, Honghua Zhang, Yueqing Su, Yao Chen, Yinglin Zeng, Qingying Lin, Wenbin Zhu
OBJECTIVE: To understand the relationship between perinatal factors and congenital hypothyroidism (CH) and provide scientific evidence for the prevention of CH. METHODS: A case-control study was conducted among 125 neonates with CH (case group) and 375 neonates without CH (control group) in Fujian Neonatal Screening Center from January in 2012 to December in 2013. Univariate and multivariate logistic regression analysis were performed to identify the risk factors to CH during perinatal period...
July 2015: Zhonghua Liu Xing Bing Xue za Zhi, Zhonghua Liuxingbingxue Zazhi
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