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hyperthyroidism pregnancy

Lana de Lourdes Aguiar Lima, Raphael Câmara Medeiros Parente, Izildinha Maestá, Joffre Amim Junior, Jorge Fonte de Rezende Filho, Carlos Antonio Barbosa Montenegro, Antônio Braga
Gestational trophoblastic disease is an abnormality of pregnancy that encompasses a group of diseases that differ from each other in their propensity for regression, invasion, metastasis, and recurrence. In the past, it was common for patients with molar pregnancy to present with marked symptoms: copious bleeding; theca lutein cysts; uterus larger than appropriate for gestational age; early preeclampsia; hyperemesis gravidarum; and hyperthyroidism. Currently, with early diagnosis made by ultrasound, most patients are diagnosed while the disease is still in the asymptomatic phase...
July 2016: Radiologia Brasileira
Satoko Kinomoto-Kondo, Nagayoshi Umehara, Shiori Sato, Kohei Ogawa, Takeo Fujiwara, Naoko Arata, Haruhiko Sago
PURPOSE: To study the effects of gestational transient thyrotoxicosis (GTT) on pregnancy outcomes. METHODS: This case-control study retrospectively analyzed 7976 women with singleton pregnancies whose thyroid function was measured before 16 weeks of gestation and who delivered at ≥22 weeks of pregnancy. GTT was defined as hyperthyroidism (free thyroxine [FT4] level: ≥95th percentile) in the early pregnancy, which normalized in mid-pregnancy without thyroid-stimulating hormone receptor antibodies...
October 20, 2016: Archives of Gynecology and Obstetrics
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
Stine Linding Andersen, Peter Laurberg
Hyperthyroidism in women who are of childbearing age is predominantly of autoimmune origin and caused by Graves' disease. The physiological changes in the maternal immune system during a pregnancy may influence the development of this and other autoimmune diseases. Furthermore, pregnancy-associated physiological changes influence the synthesis and metabolism of thyroid hormones and challenge the interpretation of thyroid function tests in pregnancy. Thyroid hormones are crucial regulators of early development and play an important role in the maintenance of a normal pregnancy and in the development of the fetus, particularly the fetal brain...
2016: International Journal of Women's Health
Nissim Arbib, Eran Hadar, Orly Sneh-Arbib, Rony Chen, Arnon Wiznitzer, Rinat Gabbay-Benziv
PURPOSE: Maternal thyroid gland dysfunction may adversely affect pregnancy outcome. We aimed to examine the association between subclinical thyroid dysfunction, both hypothyroidism and hyperthyroidism, to adverse pregnancy outcome. MATERIALS AND METHODS: Retrospective cohort study of all women with an available first trimester thyroid function testing and known pregnancy outcome, categorized to subclinical hypothyroidism, or hyperthyroidism and evaluated for complication during gestation and delivery...
October 17, 2016: Journal of Maternal-fetal & Neonatal Medicine
Loredana Cavalli, Andrea Guazzini, Luisella Cianferotti, Simone Parri, Tiziana Cavalli, Alessia Metozzi, Francesca Giusti, Caterina Fossi, Dennis M Black, Maria Luisa Brandi
BACKGROUND: BoneTour is a campaign conducted throughout the Italian territory for the assessment of Italian people bone status and for the prevention of osteoporosis. METHODS: A total of 7305 sequential subjects of both sexes were screened, collecting clinical data through the FRAX™ questionnaire, and measuring heel bone stiffness by Quantitative Ultrasonography (QUS). The 10-year risk for hip and major osteoporotic fractures was calculated taking into account personal or family history of fragility fracture, smoking, alcohol abuse, rheumatoid arthritis, prolonged steroids assumption...
2016: BMC Musculoskeletal Disorders
Ayman A Al-Talib
OBJECTIVES: To study the clinical presentation and treatment outcome of molar pregnancy at a Tertiary Care Hospital in Dammam, Saudi Arabia. MATERIALS AND METHODS: Reviewed medical records of all molar pregnancy cases among all the deliveries at a tertiary care hospital in Dammam from 2005 to 2014, after approval by institutional ethical review committee. Data abstracted included patient's age, parity, presenting symptoms, gestational age at diagnosis, uterine size, ultrasonographic findings, BhCG level at the time of diagnosis and at follow-up after evacuation, and blood loss during evacuation...
September 2016: Journal of Family & Community Medicine
Li-Hua Zhang, Jing-Yan Li, Qi Tian, Shuang Liu, Hong Zhang, Sheng Liu, Jiu-Gen Liang, Xian-Ping Lu, Ning-Yi Jiang
The aims of the present study were to analyze the outcomes of pregnancy, after (131)I treatment, in patients of reproductive age with Graves' hyperthyroidism and to investigate the effects, if any, of the (131)I treatment on the mothers and newborns. From 2009 to 2014, 257 pregnant female patients with Graves' hyperthyroidism in the outpatients at the Department of Nuclear Medicine and 166 healthy pregnant women from the Department of Obstetrics at Sun Yat-Sen Memorial Hospital were included in our study. They were divided into a (131)I therapy group (n = 130) and an anti-thyroid drug (ATD) group (n = 127) according to their therapy before conception...
September 12, 2016: Journal of Radiation Research
Onyebuchi E Okosieme, John H Lazarus
INTRODUCTION: Graves' hyperthyroidism is associated with significant morbidity and mortality risk. The thionamides, methimazole, its pro-drug derivative carbimazole, and propylthiouracil, remain a cornerstone of management. Yet despite decades of use, optimal strategies for maximising treatment response and curtailing adverse effect risk remains uncertain. AREAS COVERED: We reviewed the current literature on the evidence based medical management of Graves' disease...
October 2016: Expert Opinion on Pharmacotherapy
S L Andersen, A Carlé, J Olsen, P Laurberg
OBJECTIVE: Immunological changes in and after a pregnancy may influence the onset of autoimmune diseases. An increased incidence of hyperthyroidism has been observed both in early pregnancy and postpartum, but it remains to be studied if the incidence of hypothyroidism varies in a similar way. DESIGN: Population-based cohort study using Danish nationwide registers. METHOD: All women who gave birth to a singleton live-born child in Denmark from 1999 to 2008 (n = 403 958) were identified, and data on hospital diagnosis of hypothyroidism and redeemed prescriptions of thyroid hormone were extracted...
November 2016: European Journal of Endocrinology
John P Walsh
Serum thyroid-stimulating hormone (TSH) testing is the best screening tool for thyroid dysfunction. When TSH levels are in the reference range, additional tests such as free thyroxine, free triiodothyronine or thyroid antibodies rarely add value, except in patients with pituitary disease, when TSH is unreliable. Overt hypothyroidism and subclinical hypothyroidism with TSH levels > 10 mU/L can be treated without further investigation. The health impact of subclinical hypothyroidism with mildly elevated levels of TSH (4-10 mU/L) remains uncertain, particularly in older people; treatment or observation are reasonable options...
August 15, 2016: Medical Journal of Australia
Roberto Negro, Roberto Attanasio, Franco Grimaldi, Rinaldo Guglielmi, Enrico Papini
BACKGROUND: Patients suffering from Graves' disease (GD) are quite frequent in endocrine clinical practice. In particular, overt hyperthyroidism may be complicated by serious adverse events and requires careful treatment, but its management has changed over the years in both the USA and European Union (EU). OBJECTIVES: To evaluate the current diagnosis and management of patient's with GD in Italy, and compare results with those obtained in previous similar surveys in the USA and EU...
July 2016: European Thyroid Journal
Lokesh Kumar Sharma, Neera Sharma, Adesh Kisanji Gadpayle, Deep Dutta
BACKGROUND AND AIMS: Hyperprolactinemia has been reported in 0-57% of primary hypothyroidism. Data on hyperprolactinemia in subclinical hypothyroidism (ScH) is scant and inconsistent. This study aimed to determine the prevalence and predictors of hyperprolactinemia in ScH. METHODS: Consecutive patients diagnosed to have normal thyroid function, ScH or overt primary hypothyroidism underwent serum prolactin, gonadotropins, testosterone and estradiol estimation. Patients with pregnancy, pituitary adenomas, secondary hypothyroidism, hyperthyroidism, comorbid states and drug-induced hyperprolactinemia were excluded...
July 26, 2016: European Journal of Internal Medicine
A Freis, M Elsässer, C Sohn, H Fluhr
Twin pregnancy consisting of one fetus and one complete mole (CMCF, complete hydatidiform mole and a coexistent fetus) is an obstetric rarity with an incidence of 1/22 000 to 1/100 000 pregnancies. Associated risks include prematurity, intrauterine death, vaginal bleeding, preeclampsia, hyperthyroidism, theca lutein cysts, uterine rupture and the development of malignant neoplasia in the form of a trophoblastic tumour (GTD, persistent gestational trophoblastic disease), which is thought to be the most common complication...
July 2016: Geburtshilfe und Frauenheilkunde
Akane Ide, Nobuyuki Amino, Eijun Nishihara, Takumi Kudo, Mitsuru Ito, Yukiko Kimura, Nobuya Tatsumi, Mineo Yamazaki, Akira Miyauchi
Graves' disease often occurs after delivery. However, it has been difficult to predict who will develop Graves' hyperthyroidism. We attempted to predict postpartum onset of Graves' disease by measuring anti-TSH receptor antibodies (TRAb) and thyroid-stimulating antibodies (TSAb) in early pregnancy. TRAb was measured by a third generation assay and TSAb was measured by a newly developed sensitive bioassay. In 690 early pregnant women, 2 showed borderline TRAb positive reactions. However, none of them developed Graves' disease after delivery...
July 12, 2016: Endocrine Journal
Claire Hawken, Mélie Sarreau, Marc Bernardin, Anne-Christine Delcourt, Anne Muller, Guy Lefort, Patrice Pernollet, Richard Marechaud
: Graves' disease (GD) during pregnancy involves risks for the mother, foetus and neonate. OBJECTIVE: To compile an inventory of the clinical practices regarding the management of GD during pregnancy in the Poitou-Charentes region of France. This was a retrospective, multicentre study covering the period 2005 to 2012. Ninety-five pregnancies were reviewed: 14 GD diagnosed during pregnancy, 24 GD already treated with synthetic antithyroid drugs (SAT) prior to pregnancy, 25 GD in remission before pregnancy and 32 GD who had undergone thyroidectomy prior to pregnancy...
June 30, 2016: Annales D'endocrinologie
P Bakas, C Tzouma, M Creatsa, I Boutas, D Hassiakos
PURPOSE OF INVESTIGATION: To report a rare case of maternal hyperthyroidism after intrauterine insemination due to hypertrophic action of hCG. MATERIALS AND METHODS: A 36-year-old woman after successful intrauterine insemination and triplet pregnancy, developed hyperthyroidism with resistance to medical treatment. RESULTS: All signs of hyperthyroidism resolved and the results of thyroid function tests returned to normal without any medication after embryo meiosis...
2016: Clinical and Experimental Obstetrics & Gynecology
Ingrid Dravecká
UNLABELLED: Polycystic ovary syndrome (PCOS) is a heterogeneous and complex endocrine disease which among the female population belongs to the most widespread endocrinopathies and it is the most frequent cause of hyperthyroidism, anticoagulation and infertility. Insulin resistance is one of the important diabetology factors impacting hyperglycaemia in a majority of women with PCOS (60-80 %). Clinical expressions of PCOS include reproduction disorders, metabolic characteristics and psychological implications...
2016: Vnitr̆ní Lékar̆ství
Stine Linding Andersen, Jørn Olsen, Peter Laurberg
BACKGROUND: Hypothyroidism is a common endocrine disease. The frequency of pregnancy loss in women with known hypothyroidism as opposed to women with a later diagnosis of hypothyroidism has not been evaluated and compared with other common endocrine diseases. DESIGN: Population-based cohort study using Danish nationwide registers. PARTICIPANTS: All pregnancies in Denmark, 1997-2008, resulting in live birth (n=732,533), spontaneous abortion (n=112,487) or stillbirth (n=2,937) were identified together with information on maternal hypothyroidism, hyperthyroidism and diabetes...
June 17, 2016: Clinical Endocrinology
Peter Laurberg, Stine Linding Andersen
Thyroid hormones are essential developmental factors, and Graves' disease (GD) may severely complicate a pregnancy. This review describes how pregnancy changes the risk of developing GD, how early pregnancy by several mechanisms leads to considerable changes in the results of the thyroid function tests used to diagnose hyperthyroidism, and how these changes may complicate the diagnosing of GD. Standard therapy of GD in pregnancy is anti-thyroid drugs. However, new studies have shown considerable risk of birth defects if these drugs are used in specific weeks of early pregnancy, and this should be taken into consideration when planning therapy and control of women who may in the future become pregnant...
November 2016: European Journal of Endocrinology
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