Thyroid function testing in pregnancy: 2017 ATA guidelines update. Dr Simon Forehan
|
|
- Lisa Owen
- 5 years ago
- Views:
Transcription
1 Thyroid function testing in pregnancy: 2017 ATA guidelines update Dr Simon Forehan
2 Several factors are known to tax gravid thyroid economy: Increased plasma volume TBG pool increased Renal clearance Feto-placental unit uptake Placental deiodination
3 Homology of TSH and hcg Same alpha sub-unit 85% homology beta sub-unit hcg has thyromimetic effects and is responsible for the hyperthyroidism associated with trophoblastic disease.
4 TSH HCG Glinoer et al JCEM 1990
5 II: TSH reference range
6 ATA guidelines 2017 RECOMMENDATION 1 When possible, population-based trimester-specific reference ranges for serum TSH should be defined through assessment of local population data representative of a health care provider s practice. Reference range determinations should only include pregnant women with no known thyroid disease, optimal iodine intake, and negative TPOAb status. Alexander THYROID 2017
7 Organisation American Thyroid Association, 2011 TSH (miu/l) First trimester Second trimester Third trimester Endocrine Society, 2012 First trimester <2.5 Second trimester <3.0 Third trimester <3.0 European Thyroid Association, 2014 First trimester <2.5 Second trimester <3.0 Third trimester <3.5
8 ATA guidelines 2011
9 ATA guidelines 2011
10 ATA guidelines th to 95 th percentiles
11 Generation R study Trimester TSH 2.5 mu/l 2.5 th and 97.5th TSH (mu/l) 1st 8.6% nd 4.9% Medici JCEM 2012
12 Of 19 studies, 97.5th TSH <2.5 mu/l in only 1 study 14 studies 97.5th TSH >3 mu/l
13 ATA guidelines 2017 Question 31: What is the definition of hypothyroidism in pregnancy? RECOMMENDATION 25 In the setting of pregnancy, maternal hypothyroidism is defined as a TSH concentration elevated beyond the upper limit of the pregnancy-specific reference range. Strong recommendation, high-quality evidence.
14 ATA guidelines 2017 RECOMMENDATION 26 The pregnancy-specific TSH reference range should be defined as follows:
15 ATA guidelines 2017 RECOMMENDATION 26 The pregnancy-specific TSH reference range should be defined as follows: When available, population- and trimester-specific reference ranges for serum TSH during pregnancy should be defined by a provider s institute or laboratory and should represent the typical population for whom care is provided. Reference ranges should be defined in healthy TPOAb-negative pregnant women with optimal iodine intake and without thyroid illness. Strong recommendation, high-quality evidence.
16 ATA guidelines 2017 RECOMMENDATION 26 The pregnancy-specific TSH reference range should be defined as follows: When available, population- and trimester-specific reference ranges for serum TSH during pregnancy should be defined by a provider s institute or laboratory and should represent the typical population for whom care is provided. Reference ranges should be defined in healthy TPOAb-negative pregnant women with optimal iodine intake and without thyroid illness. Strong recommendation, high-quality evidence. When this goal is not feasible, pregnancy-specific TSH reference ranges obtained from similar patient populations and performed using similar TSH assays should be substituted. Strong recommendation, high-quality evidence.
17 ATA guidelines 2017 RECOMMENDATION 26 If internal or transferable pregnancy-specific TSH reference ranges are not available, an upper reference limit of 4.0 mu/l may be used. For most assays, this limit represents a reduction in the nonpregnant TSH upper reference limit of 0.5 mu/l. Strong recommendation, moderate-quality evidence.
18 Analytical method Ethnic differences Multiple pregnancy Iodine sufficiency Diurnal variation
19 Predictable changes to thyroid function in pregnancy limited availability of trimester-specific reference ranges calculated for most ethnic and racial populations with adequate iodine intake who are free of thyroid autoantibodies
20 Hierarchy: i. Emphasis on population-based trimester-specific reference ranges for serum TSH ii. Comparable population and assay iii. Revision of prescriptive reference ranges reduce lower range TSH by approx 0.4 mu/l Reduced upper reference range is reduced by approx 0.5 mu/l in early pregnancy, this corresponds to a TSH upper reference limit of 4.0 mu/l applied beginning with the late first trimester, weeks 7 12, with a gradual return towards the non-pregnant range in the second and third trimesters.
21
22 Adjusted OR of Miscarriage < >10 TSH mu/l Taylor JCEM 2014
23 Euthyroid ab positive women Negro JCEM 2006
24 12 Miscarriage, % Euthyroid SCH Isolated TAI TAI + SCH Lui THYROID 2014
25 ATA guidelines 2017 RECOMMENDATION 28 Pregnant women with TSH concentrations >2.5mU/L should be evaluated for TPOAb status.
26 ATA guidelines 2017 RECOMMENDATION 29 Subclinical hypothyroidism in pregnancy should be approached as follows: a) LT4 therapy is recommended for - TPOAb-positive women with a TSH greater than the pregnancyspecific reference range (see Recommendation 1). Strong recommendation, moderate-quality evidence. - TPOAb-negative women with a TSH greater than 10.0 mu/l. Strong recommendation, low-quality evidence.
27 ATA guidelines 2017 RECOMMENDATION 29 Subclinical hypothyroidism in pregnancy should be approached as follows: (b) LT4 therapy may be considered for - TPOAb-positive women with TSH concentrations >2.5mU/L and below the upper limit of the pregnancy-specific reference range. Weak recommendation, moderate-quality evidence. - TPOAb-negative women and TPOAb-negative women with TSH concentrations greater than the pregnancy- specific reference range and below 10.0 mu/l. Weak recommendation, low-quality evidence.
28 ATA guidelines 2017 RECOMMENDATION 29 Subclinical hypothyroidism in pregnancy should be approached as follows: (c) LT4 therapy is not recommended for - TPOAb-negative women with a normal TSH (TSH within the pregnancy-specific reference range or <4.0 mu/l if unavailable). Strong recommendation, high-quality evidence.
29
30
Thyroid Disease in Pregnancy: The Essentials. Elizabeth N. Pearce, MD, MSc
Thyroid Disease in Pregnancy: The Essentials Elizabeth N. Pearce, MD, MSc None Disclosures Case 1 A 31-year-old woman from Massachusetts is practicing a vegan diet. She is currently planning a pregnancy.
More informationLecture title. Name Family name Country
Lecture title Name Family name Country Nguyen Thy Khue, MD, PhD Department of Endocrinology HCMC University of Medicine and Pharmacy, MEDIC Clinic Hochiminh City, Viet Nam Provided no information regarding
More informationShould every pregnant woman be screened for thyroid disease?
Should every pregnant woman be screened for thyroid disease? Tal Biron-Shental Rinat Gabbay-Benziv Is there a debate? Thyroid screening Guidelines Targeted case finding criteria Age > 30 years Personal
More informationHypothyroidism in pregnancy. Nor Shaffinaz Yusoff Azmi Jabatan Perubatan Hospital Sultanah Bahiyah Kedah
Hypothyroidism in pregnancy Nor Shaffinaz Yusoff Azmi Jabatan Perubatan Hospital Sultanah Bahiyah Kedah Agenda 1. Epidemiology and clinical characteristics of maternal hypothyroidism 2. Prevention and
More informationThyroid. Dr Jessica Triay November 2018
Thyroid Dr Jessica Triay November 2018 Hypothyroidism in Pregnancy Clinical update: Hypothyroidism in Pregnancy Take home messages Additional evidence supportive for more relaxed TSH targets for those
More informationIodine and Thyroid Hormones
Iodine and Thyroid Hormones Iodine and Thyroid Hormones feed-back Iodine Deficiency Characteristics Iodine Deficiency None Mild Mode Severe Median urine iodine >100 50-99 20-49
More informationThyrotoxicosis in Pregnancy: Diagnose and Management
Thyrotoxicosis in Pregnancy: Diagnose and Management Yuanita Asri Langi email: meralday@yahoo.co.id Endocrinology & Metabolic Division, Internal Medicine Department, Prof.dr.R.D. Kandou Hospital/ Sam Ratulangi
More informationUpdate on Gestational Thyroid Disease. Aidan McElduff The Discipline of Medicine, The University of Sydney
IADPSG 2016 Update on Gestational Thyroid Disease Aidan McElduff The Discipline of Medicine, The University of Sydney IADPSG 2016 DISCLOSURES and AIM Nil to disclose Aim: to provide an overview 2017 Guidelines
More informationTHE TREATMENT OF HYPOTHYROIDISM IN PREGNANCY
2017 ILEX PUBLISHING HOUSE, Bucharest, Roumania http://www.jrdiabet.ro Rom J Diabetes Nutr Metab Dis. 24(2):155-160 doi: 10.1515/rjdnmd-2017-0020 THE TREATMENT OF HYPOTHYROIDISM IN PREGNANCY Rucsandra
More informationThis is the author s final accepted version.
Carty, D. M., Doogan, F., Welsh, P., Dominiczak, A. F., and Delles, C. (2017) Thyroid stimulating hormone (TSH) 2.5mU/l in early pregnancy: prevalence and subsequent outcomes. European Journal of Obstetrics
More informationThe Presence of Thyroid Autoantibodies in Pregnancy
The Presence of Thyroid Autoantibodies in Pregnancy Dr. O Sullivan does not have any financial relationships with any commercial interests. KATIE O SULLIVAN, MD FELLOW, ADULT/PEDIATRIC ENDOCRINOLOGY ENDORAMA
More informationThe Thyroid and Pregnancy OUTLINE OF DISCUSSION 3/19/10. Francis S. Greenspan March 19, Normal Physiology. 2.
The Thyroid and Pregnancy Francis S. Greenspan March 19, 2010 OUTLINE OF DISCUSSION 1. Normal Physiology 2. Hypothyroidism 3. Hyperthyroidism 4. Thyroid Nodules and Cancer NORMAL PHYSIOLOGY Iodine Requirements:
More informationHypothyroidism and Hyperthyroidism. Paul V. Tomasic, MD, MS, FACP, FACE Nevada AACE EFNE & Annual Meeting October 6, 2018
Hypothyroidism and Hyperthyroidism Paul V. Tomasic, MD, MS, FACP, FACE Nevada AACE EFNE & Annual Meeting October 6, 2018 Disclosures: None related to this program or presentation Objectives: Hypothyroidism
More informationThyroid Disease & Pregnancy Updates and Ongoing Questions
Thyroid Disease & Pregnancy - 2018 Updates and Ongoing Questions Erik K. Alexander, MD Chief, Thyroid Section, Division of Endocrinology Brigham & Women s Hospital Professor of Medicine, Harvard Medical
More informationEffect of mildly elevated thyroid-stimulating hormone during the first trimester on adverse pregnancy outcomes
Li et al. BMC Endocrine Disorders (2018) 18:64 https://doi.org/10.1186/s12902-018-0294-7 RESEARCH ARTICLE Open Access Effect of mildly elevated thyroid-stimulating hormone during the first trimester on
More informationLothian Guidance for Diagnosis and Management of Thyroid Dysfunction in Pregnancy
Lothian Guidance for Diagnosis and Management of Thyroid Dysfunction in Pregnancy Early diagnosis and good management of maternal thyroid dysfunction are essential to ensure minimal adverse effects on
More informationSCREENING FOR THYROID DYSFUNCTION U S P S T F R E C O M M E N D A T I O N S T A T E M E N T M A R I A S T U R L A 8 M A Y 2015
SCREENING FOR THYROID DYSFUNCTION U S P S T F R E C O M M E N D A T I O N S T A T E M E N T M A R I A S T U R L A 8 M A Y 2015 BACKGROUND Thyroid dysfunction represents a continuum from asymptomatic biochemical
More informationHypothyroidism in Pregnancy
Chapter 2 Hypothyroidism in Pregnancy Baha Zantour, Wafa Alaya, Hela Marmouch and Wafa Chebbi Additional information is available at the end of the chapter http://dx.doi.org/10.5772/54745 1. Introduction
More informationReview Article Think Thyroid - Think Life: Pregnancy with Thyroid Disorders
Chettinad Health City Medical Journal Muthukumaran Jayapaul* Consultant Endocrinologist, Arka Center for Hormonal Health, Chennai, India Dr. Muthu Kumaran Jayapaul is a Consultant Endocrinologist and also
More informationMaternal overt and Subclincal hypothyroidism, and the risk of miscarriage in Iraq
International Journal of Advanced Research in Biological Sciences ISSN: 2348-8069 www.ijarbs.com DOI: 10.22192/ijarbs Coden: IJARQG(USA) Volume 5, Issue 5-2018 Research Article DOI: http://dx.doi.org/10.22192/ijarbs.2018.05.05.014
More informationClinical THYROIDOLOGY
Clinical THYROIDOLOGY Editor-in Chief Jerome M. Hershman, MD Distinguished Professor of Medicine UCLA School of Medicine and VA Greater Los Angeles Healthcare System Endocrinology 111D, 11301 Wilshire
More informationTimothy Bilash MD MS OBG Northern Inyo Hospital, Bishop, CA October 20, :30 PM
Thyroxine Deficiency in Pregnancy Timothy Bilash MD MS OBG Northern Inyo Hospital, Bishop, CA October 20, 2006 1:30 PM WHI Estrogen recap In http://courses.washington.edu/bonephys/opestrogen.html. from:
More informationPitfalls of TFTs Interpretation
Mohammad Reza Bakhtiari DCLS, PhD Pitfalls of TFTs Interpretation CME July 2006 Vol.24 No.7, http://keck.usc.edu HPT axis physiology Log-linear relationship between TSH and FT4 Patient Specific Set Point
More informationReview of Literature
Review of Literature 2. REVIEW OF LITERATURE The review of literature is broadly explained into following headings & subheadings 2.1 Pregnancy and maternal fetal interactions 2.2 Pregnancy and associated
More information2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum
THYROID Volume 27, Number 3, 2017 ª American Thyroid Association ª Mary Ann Liebert, Inc. DOI: 10.1089/thy.2016.0457 SPECIAL ARTICLE 2017 Guidelines of the American Thyroid Association for the Diagnosis
More informationDownloaded from by guest on 18 September 2018
ORIGINAL ARTICLE Endocrine Care Assessment of Thyroid Function During First- Trimester Pregnancy: What Is the Rational Upper Limit of Serum TSH During the First Trimester in Chinese Pregnant Women? Chenyan
More informationLothian Guidance for Diagnosis and Management of Thyroid Dysfunction in Pregnancy.
Lothian Guidance for Diagnosis and Management of Thyroid Dysfunction in Pregnancy. Early diagnosis and good management of maternal thyroid dysfunction is essential to ensure minimal adverse effects on
More informationThyroid function in pregnancy
Published Online December 23, 2010 Thyroid function in pregnancy John H. Lazarus * Centre for Endocrine and Diabetes Sciences, Cardiff University School of Medicine, University Hospital of Wales, Heath
More informationB-Resistance to the action of hormones, Hormone resistance characterized by receptor mediated, postreceptor.
Disorders of the endocrine system 38 Disorders of endocrine system mainly are caused by: A-Deficiency or an excess of a single hormone or several hormones: - deficiency :can be congenital or acquired.
More informationBeneficial effects on pregnancy outcomes of thyroid hormone replacement for subclinical hypothyroidism
The University of Notre Dame Australia ResearchOnline@ND Medical Papers and Journal Articles School of Medicine 2017 Beneficial effects on pregnancy outcomes of thyroid hormone replacement for subclinical
More informationTable 1: Thyroid panel. Result (reference interval) TSH 89.5 miu/l ( ) Total T4 5.2 µg/dl ( ) T3 uptake 39% (22-35)
Introduction Thyroid disease is the second most common endocrine disorder (behind diabetes), and its prevalence increases with increasing age. The incidence of newly diagnosed thyroid cancer is increasing
More informationHypothyroidism in pregnancy
Review Article Page 1 of 8 Hypothyroidism in pregnancy Fahimeh Ramezani Tehrani, Samira Behboudi-Gandevani Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid
More informationCROSS TOWN ENDOCRINE CLUB. Alex S. Stagnaro-Green, M.D. THURSDAY, OCTOBER 22, 2009
CROSS TOWN ENDOCRINE CLUB Alex S. Stagnaro-Green, M.D. Professor of Medicine, Professor of Obstetrics & Gynecology Touro University College of Medicine Hackensack, New Jersey USC School of Medicine Visiting
More informationNIH Public Access Author Manuscript Ther Drug Monit. Author manuscript; available in PMC 2013 April 14.
NIH Public Access Author Manuscript Published in final edited form as: Ther Drug Monit. 2006 February ; 28(1): 8 11. Thyroid Function Testing in Pregnancy and Thyroid Disease: Trimester-specific Reference
More informationThyroid function in pregnancy
Review Article Page 1 of 16 Thyroid function in pregnancy Ilaria Muller #, Peter N. Taylor #, John H. Lazarus Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine,
More informationLABORATORY TESTS FOR EVALUATION OF THYROID DISORDERS
LABORATORY TESTS FOR EVALUATION OF THYROID DISORDERS Maryam Tohidi Anatomical & clinical pathologist Research Institute for Endocrine Sciences THYROID GLAND (15-25 gr), (12-20 gr), 2 lobes connected by
More informationUnderstanding the Thyroid and Pregnancy
FERTILITY nurses first Understanding the Thyroid and Pregnancy Tamara Tobias, ARNP Human chorionic gonadotropin (hcg) and estrogen are two hormones that play an important role during pregnancy. They can,
More informationHyperthyroidism and Hypothyroidism in Pregnancy Guideline
Aneurin Bevan University Health Board Hyperthyroidism and Hypothyroidism in Pregnancy Guideline N.B. Staff should be discouraged from printing this document. This is to avoid the risk of out of date printed
More informationSubclinical Hypothyroidism and Isolated Hypothyroxinemia during Pregnancy and Their Association with Pregnancy Outcome: A 2-Year Study
Open Journal of Obstetrics and Gynecology, 2017, 7, 693-701 http://www.scirp.org/journal/ojog ISSN Online: 2160-8806 ISSN Print: 2160-8792 Subclinical Hypothyroidism and Isolated Hypothyroxinemia during
More informationMichaela Granfors, Helena Åkerud, Anna Berglund, Johan Skogö, Inger Sundström-Poromaa, and Anna-Karin Wikström
ORIGINAL ARTICLE Endocrine Care Thyroid Testing and Management of Hypothyroidism During Pregnancy: A Population-based Study Michaela Granfors, Helena Åkerud, Anna Berglund, Johan Skogö, Inger Sundström-Poromaa,
More informationResearch Article Trimester- and Assay-Specific Thyroid Reference Intervals for Pregnant Women in China
International Endocrinology Volume 2016, Article ID 3754213, 5 pages http://dx.doi.org/10.1155/2016/3754213 Research Article Trimester- and Assay-Specific Thyroid Reference Intervals for Pregnant Women
More information2004 Where Do We Go from Here? Summary of Working Group Discussions on Thyroid Function and Gestational Outcomes
THYROID Volume 15, Number 1, 2005 Mary Ann Liebert, Inc. 2004 Where Do We Go from Here? Summary of Working Group Discussions on Thyroid Function and Gestational Outcomes Joseph G. Hollowell, 1 Stephen
More informationJMSCR Vol 06 Issue 11 Page November 2018
www.jmscr.igmpublication.org Impact Factor (SJIF): 6.379 Index Copernicus Value: 79.54 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v6i11.40 Prevalence of Thyroid autoimmunity
More informationResearch Article Impaired Fertility Associated with Subclinical Hypothyroidism and Thyroid Autoimmunity: The Danish General Suburban Population Study
Pregnancy Volume 2015, Article ID 132718, 6 pages http://dx.doi.org/10.1155/2015/132718 Research Article Impaired Fertility Associated with Subclinical Hypothyroidism and Thyroid Autoimmunity: The Danish
More informationThyroid dysfunction and subfertility
REVIEW pissn 2233-8233 eissn 2233-8241 Clin Exp Reprod Med 2015;42(4):131-135 Thyroid dysfunction and subfertility Moon Kyoung Cho Department of Obstetrics and Gynecology, Chonnam National University Medical
More informationNone. Thyroid Potpourri for the Primary Care Physician. Evaluating Thyroid Function. Disclosures. Learning Objectives
Thyroid Potpourri for the Primary Care Physician Ramya Vedula DO, MPH, ECNU Endocrinology, Diabetes and Metabolism Princeton Medical Group Assistant Professor of Clinical Medicine Rutgers Robert Wood Johnson
More informationThyroid Function TSH Analyte Information
Thyroid Function TSH Analyte Information 1 2013-05-01 Thyroid-stimulating hormone (TSH) Introduction Thyroid-stimulating hormone (thyrotropin, TSH) is a glycoprotein with molecular weight of approximately
More informationThyroid Dysfunction during Pregnancy: A Review of the Current Guidelines
, pp: 130-136 (ISSN: 2455-1716) Impact Factor 2.4 MARCH-2016 Review Article (Open access) Thyroid Dysfunction during Pregnancy: A Review of the Current Guidelines Mustafa Al Abousi* Department of Endocrinology,
More informationClinical Study Further Evidence on the Role of Thyroid Autoimmunity in Women with Recurrent Miscarriage
International Endocrinology Volume 2012, Article ID 717185, 4 pages doi:10.1155/2012/717185 Clinical Study Further Evidence on the Role of Thyroid Autoimmunity in Women with Recurrent Miscarriage Natalia
More informationThyroid function after assisted reproductive technology in women free of thyroid disease
Thyroid function after assisted reproductive technology in women free of thyroid disease Kris Poppe, M.D., a Daniel Glinoer, M.D., Ph.D., b Herman Tournaye, M.D., Ph.D., c Johan Schiettecatte, c Patrick
More informationHypothyroidism. Definition:
Definition: Hypothyroidism Primary hypothyroidism is characterized biochemically by a high serum thyroidstimulating hormone (TSH) concentration and a low serum free thyroxine (T4) concentration. Subclinical
More informationUnderstanding thyroid function tests. Dr. Colette George
Understanding thyroid function tests Dr. Colette George Disclosures No financial disclosure I will present fictitious cases and thyroid function tests (TFTs) that are based on scenarios I commonly encounter.
More informationThe e-supplementary online content file_1: The Study Protocol
The e-supplementary online content file_1: The Study Protocol Supplement1_English: English Version of the Study Protocol Supplement1_Chinese: Chinese Version of the Study Protocol Supplement1_Ethical Approval:
More informationSubclinical hypothyroidism and hypothyroidism in pregnancy
Subclinical hypothyroidism and hypothyroidism in pregnancy This statement has been developed and reviewed by the Women s Health Committee and approved by the RANZCOG Board and Council. A list of Women
More informationCommon Issues in Management of Hypothyroidism
Common Issues in Management of Hypothyroidism Family Medicine Refresher Course April 5, 2018 Janet A. Schlechte, M.D. Disclosure of Financial Relationships Janet A. Schlechte, M.D. has no relationships
More informationPage 1. Understanding Common Thyroid Disorders. Cases. Topics Covered
Cases Understanding Common Thyroid Disorders Douglas C. Bauer, MD UCSF Division of General Internal Medicine No Disclosures 66 yr old female with 1 yr of fatigue and lassitude and no findings except TSH=8.2,
More informationUncommon Presentations of Thyroid Dysfunction. Douglas S Ross MD May 16, 2018 Copyrighted slides omitted
Uncommon Presentations of Thyroid Dysfunction Douglas S Ross MD May 16, 2018 Copyrighted slides omitted Case 1 53 year old woman Sees her PCP with complaints of fatigue She is sleeping poorly due to hot
More informationThyroid disease and female reproduction
Clinical Endocrinology (2007) 66, 309 321 doi: 10.1111/j.1365-2265.2007.02752.x REVIEW ARTICLE Blackwell Publishing Ltd Thyroid disease and female reproduction Kris Poppe*, Brigitte Velkeniers* and Daniel
More informationResearch. Although thyrotropin (thyroidstimulated
Research www.ajog.org OBSTETRICS Free T4 immunoassays are flawed during pregnancy Richard H. Lee, MD; Carole A. Spencer, PhD; Jorge H. Mestman, MD; Erin A. Miller, BS; Ivana Petrovic, MS; Lewis E. Braverman,
More informationThyroid disease symptoms during early pregnancy do not identify women with thyroid hypofunction that should be treated
Received: 7 May 2017 Revised: 20 July 2017 Accepted: 22 July 2017 DOI: 10.1111/cen.13433 ORIGINAL ARTICLE Thyroid disease symptoms during early pregnancy do not identify women with thyroid hypofunction
More informationManagement of gestational hypothyroidism: results of a Brazilian survey
original article Management of gestational hypothyroidism: results of a Brazilian survey 1 Endocrinologia e Metabolismo, Pontifícia Universidade Católica de Campinas (PUC-Campinas). Laboratório de Genética
More informationPLACE OF SELENIUM IN THE TREATMENT OF THYROID DISEASES
VII, 2013, 2 27, PLACE OF SELENIUM IN THE TREATMENT OF THYROID DISEASES D. Gavrailova Faculty of Public Health, Medical University So a : (Se).,. Se, - (, )., Se., Se -. :,,, :,, Summary: The essential
More informationReview Article Levothyroxine Treatment in Pregnancy: Indications, Efficacy, and Therapeutic Regimen
SAGE-Hindawi Access to Research Journal of Thyroid Research Volume 2011, Article ID 843591, 12 pages doi:10.4061/2011/843591 Review Article Levothyroxine Treatment in Pregnancy: Indications, Efficacy,
More informationHyperthyroidism. Objectives. Clinical Manifestations. Slide 1. Slide 2. Slide 3. Implications for Primary Care. hyperthyroidism
1 Hyperthyroidism Implications for Primary Care Laura A. Ruby, DNP, CRNP Wellspan Endocrinology 2 Objectives! Discuss the clinical manifestations of hyperthyroidism! Review the use of the diagnostic studies!
More informationGrave s disease (1 0 )
THYROID DYSFUNCTION Grave s disease (1 0 ) Autoimmune - activating AB s to TSH receptor High concentrations of circulating thyroid hormones Weight loss, tachycardia, tiredness Diffuse goitre - TSH stimulating
More informationEsther Briganti. Fetal And Maternal Health Beyond the Womb: hot topics in endocrinology and pregnancy. Endocrinologist and Clinician Researcher
Fetal And Maternal Health Beyond the Womb: hot topics in endocrinology and pregnancy Esther Briganti Endocrinologist and Clinician Researcher Director, Melbourne Endocrine Associates Associate Professor,
More informationWe are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors
We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 4,100 116,000 120M Open access books available International authors and editors Downloads Our
More informationPearls and Pitfalls of Thyroid Diagnosis. Todd W. Frieze, MD, FACP, FACE, ECNU, CCD Endocrine Care, Hattiesburg Clinic Biloxi MS
Pearls and Pitfalls of Thyroid Diagnosis Todd W. Frieze, MD, FACP, FACE, ECNU, CCD Endocrine Care, Hattiesburg Clinic Biloxi MS Thyroid Anatomy Isthmus of gland located 1 fingerbreadth below cricoid cartilage
More informationA prospective observational study of thyroid dysfunctions during pregnancy in a tertiary care hospital
International Journal of Reproduction, Contraception, Obstetrics and Gynecology Chunchaiah S et al. Int J Reprod Contracept Obstet Gynecol. 2016 Nov;5(11):3683-3689 www.ijrcog.org pissn 2320-1770 eissn
More informationPrevalence of thyroid disorder in pregnancy and pregnancy outcome
Original Research Article Prevalence of thyroid disorder in pregnancy and pregnancy outcome Rama Saraladevi 1*, T Nirmala Kumari 1, Bushra Shreen 2, V. Usha Rani 3 1 Associate Professor, 2 Senior Resident,
More informationUpdate In Hyperthyroidism
Update In Hyperthyroidism CME Away India & Sri Lanka March 23 - April 7, 2018 Richard A. Bebb MD, ABIM, FRCPC Consultant Endocrinologist Medical Subspecialty Institute Cleveland Clinic Abu Dhabi Copyright
More informationGOITER and Shortness of Breath. Case A: GOITER. Learning Objectives. Common Thyroid Disorders for
2:25 3:05pm Diagnosing and Treating Thyroid Disorders SPEAKER John Tayek, MD Presenter Disclosure Information The following relationships exist related to this presentation: John Tayek, MD, serves on the
More informationRequesting and Management of abnormal TFTs.
Requesting and Management of abnormal TFTs. At the request of a number of GPs I have produced summary guidelines surrounding thyroid testing. These have been agreed with our Endocrinology leads Dr Bell
More informationTHE PHARMA INNOVATION - JOURNAL Assessment of Antithyroperoxidase Antibodies and Thyroid Hormones Among Sudanese Pregnant Women
Received: 01-09-2013 Accepted: 30-09-2013 ISSN: 2277-7695 CODEN Code: PIHNBQ ZDB-Number: 2663038-2 IC Journal No: 7725 Vol. 2 No. 9 2013 Online Available at www.thepharmajournal.com THE PHARMA INNOVATION
More informationReview Article Management of Hyperthyroidism in Pregnancy: Comparison of Recommendations of American Thyroid Association and Endocrine Society
Thyroid Research Volume 2013, Article ID 878467, 6 pages http://dx.doi.org/10.1155/2013/878467 Review Article Management of Hyperthyroidism in Pregnancy: Comparison of of American Thyroid Association and
More informationPregnancy & Thyroid. Zohreh Moosavi Associate professor of Endocriology Imam Reza General Hospital Mashad University. Imam Reza weeky Conferance
Pregnancy & Thyroid Zohreh Moosavi Associate professor of Endocriology Imam Reza General Hospital Mashad University Imam Reza weeky Conferance Objectives Thyroid Disorders & Pregnancy Normal thyroid phsyiology
More informationRole of anti-thyroid peroxidase antibodies in adverse pregnancy outcomes
International Journal of Reproduction, Contraception, Obstetrics and Gynecology Gupta A et al. Int J Reprod Contracept Obstet Gynecol. 2016 Sept;5(9):3001-3005 www.ijrcog.org pissn 2320-1770 eissn 2320-1789
More informationDetermination of reference intervals of thyroid markers during pregnancy in Urban area of District Rawalpindi Pakistan
1488 RESEARCH ARTICLE Determination of reference intervals of thyroid markers during pregnancy in Urban area of District Rawalpindi Pakistan Mehwish Gilani, 1 Naveed Asif, 2 Ammad Akram, 3 Mehreen Gilani,
More informationInternational Journal of Research and Review E-ISSN: ; P-ISSN:
International Journal of Research and Review www.gkpublication.in E-ISSN: 2349-9788; P-ISSN: 2454-2237 Original Research Article Thyroid Dysfunction and Possible Role of Anti-TPO in Infertility Sunita
More informationClinical efficacy of therapeutic intervention for subclinical hypothyroidism during pregnancy
Clinical efficacy of therapeutic intervention for subclinical hypothyroidism during pregnancy R. Ju 1, L. Lin 2, Y. Long 2, J. Zhang 2 and J. Huang 2 1 Gynaecology and Obstetrics Department, Beijing Chuiyangliu
More informationBiomedical Research 2017; 28 (1):
Biomedical Research 2017; 28 (1): 309-314 ISSN 0970-938X www.biomedres.info Association between the clinical classification of hypothyroidism and maternal and foetal outcomes, and the effects of levothyroxine
More informationThe Number Games and Thyroid Function Arshia Panahloo Consultant Endocrinologist St George s Hospital
The Number Games and Thyroid Function Arshia Panahloo Consultant Endocrinologist St George s Hospital Presentation Today: Common thyroid problems and treatments Pregnancy related thyroid problems The suppressed
More informationThyroid autoimmunity and miscarriage
HORMONES 2008, 7(4):294-302 Review Thyroid autoimmunity and miscarriage Athina Kaprara, Gerasimos E. Krassas Department of Endocrinology, Diabetes and Metabolism, Panagia General Hospital, Thessaloniki,
More informationThyroid Disease in Pregnancy. Justin Moore, MD
Thyroid Disease in Pregnancy Justin Moore, MD Case 1 22 yr old G1P0 female at 14 2/7 weeks presents with tremor Weight stable since first positive pregnancy test Some nausea, rare vomiting TSH 0.02 miu/l,
More informationTHYROID HORMONAL STATUS IN PREGNANCY AND PRE- ECLAMPSIA AND ITS CORRELATION WITH MATERNAL AGE AND PARITY
THYROID HORMONAL STATUS IN PREGNANCY AND PRE- ECLAMPSIA AND ITS CORRELATION WITH MATERNAL AGE AND PARITY *P. Jain and R. Devi Department of Biochemistry, Gauhati Medical College and Hospital, Assam, India
More informationGuidance for Thyroid Function Testing in Primary Care in Lothian
Guidance for Thyroid Function Testing in Primary Care in Lothian In July 2006 following a lengthy consultation process, a joint working group comprising representatives from the Association of Clinical
More informationManagement of Common Thyroid Disorders
Management of Common Thyroid Disorders Douglas C. Bauer, MD UCSF Division of General Internal Medicine No Disclosures Cases 68 yr old woman with new atrial fibrillation and no other findings except TSH=0.04,
More informationDecoding Your Thyroid Tests and Results
Decoding Your Thyroid Tests and Results Wondering about your thyroid test results? Learn about each test and what low, optimal, and high results may mean so you can work with your doctor to choose appropriate
More informationEvaluation of maternal thyroid function during pregnancy: the importance of using gestational age-specific reference intervals
European Journal of Endocrinology (2007) 157 509 514 ISSN 0804-4643 CLINICAL STUDY Evaluation of maternal thyroid function during pregnancy: the importance of using gestational age-specific reference intervals
More informationThyroid disorders in antenatal women in a rural hospital in central India
International Journal of Reproduction, Contraception, Obstetrics and Gynecology Mahajan KS et al. Int J Reprod Contracept Obstet Gynecol. 2016 Jan;5(1):62-67 www.ijrcog.org pissn 2320-1770 eissn 2320-1789
More informationNeonatal Thyrotoxicosis Management of babies born to mothers with a history of hyperthyroidism (Grave s Disease)
MCN for Neonatology West of Scotland Neonatal Guideline Neonatal Thyrotoxicosis Management of babies born to mothers with a history of hyperthyroidism (Grave s Disease) This document is applicable to all
More informationMaternal and perinatal outcome in antenatal women with hypothyroidism
Original Research Article Maternal and perinatal outcome in antenatal women with hypothyroidism Polumuru Usha Devi 1, Gundu Vanaja 1* 1 Assistant Professor of Obstetrics and Gynecology, Andhra Medical
More informationSouthern Derbyshire Shared Care Pathology Guidelines. Hyperthyroidism
Southern Derbyshire Shared Care Pathology Guidelines Hyperthyroidism Purpose of Guideline The management and referral criteria of patients with newly diagnosed hyperthyroidism. Background Hyperthyroidism
More informationTSH should be measured in any women with symptoms of hypothyroidism. Screening of asymptomatic women is reviewed below. (See 'Screening' below.
Official reprint from UpToDate www.uptodate.com 2017 UpToDate Hypothyroidism during pregnancy: Clinical manifestations, diagnosis, and treatment Author: Douglas S Ross, MD Section Editors: David S Cooper,
More informationThyroid Disease: The Subtle, the Controversial, and the Complex
Thyroid Disease: The Subtle, the Controversial, and the Complex Learning Objectives After participating in this educational activity, participants should be better able to 1. Recognize the common and less
More informationMaternal outcome in thyroid dysfunction
International Journal of Reproduction, Contraception, Obstetrics and Gynecology Manju VK et al. Int J Reprod Contracept Obstet Gynecol. 2017 Jun;6(6):2361-2365 www.ijrcog.org DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20172313
More informationClinical Study Risk-Based Screening for Thyroid Dysfunction during Pregnancy
Pregnancy Volume 2013, Article ID 619718, 5 pages http://dx.doi.org/10.1155/2013/619718 Clinical Study Risk-Based Screening for Thyroid Dysfunction during Pregnancy Masanao Ohashi, 1 Seishi Furukawa, 2
More informationReview Article Screening for Maternal Thyroid Dysfunction in Pregnancy: A Review of the Clinical Evidence and Current Guidelines
Thyroid Research Volume 2013, Article ID 851326, 8 pages http://dx.doi.org/10.1155/2013/851326 Review Article Screening for Maternal Thyroid Dysfunction in Pregnancy: A Review of the Clinical Evidence
More informationHigher maternal TSH levels in pregnancy are associated with increased risk for miscarriage, fetal or neonatal death
European Journal of Endocrinology (2009) 160 985 991 ISSN 0804-4643 CLINICAL STUDY Higher maternal TSH levels in pregnancy are associated with increased risk for miscarriage, fetal or neonatal death N
More information