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Thyroid function should be normalised prior to conception in women with pre-existing thyroid disease. Once pregnancy is confirmed the thyroxine dose should be increased by about 30-50% and subsequent titrations should be guided by thyroid function tests (FT4 and TSH) that should be monitored 4-6 weekly until euthyroidism is achieved.
This is a shortened version of the eleventh chapter of the ICD-9: Complications of Pregnancy, Childbirth, and the Puerperium. It covers ICD codes 630 to 679 . The full chapter can be found on pages 355 to 378 of Volume 1, which contains all (sub)categories of the ICD-9.
Thyroid hormones, T4 and TSH, diffuse across the placenta traveling from the mother to fetus for 10–12 weeks before the fetus’s own thyroid gland can begin synthesizing its own thyroid hormones. [2] The mother continues to supply some T4 to the fetus even after he/she is able to synthesize his/her own.
[4] [5] Presence of these types of complications can have implications on monitoring lab work, imaging, and medical management during pregnancy. [4] Severe complications of pregnancy, childbirth, and the puerperium are present in 1.6% of mothers in the US, [6] and in 1.5% of mothers in Canada. [7]
While TSH-based screening will identify the most common causes, the addition of T 4 testing is required to pick up the rarer central causes of neonatal hypothyroidism. [29] If T 4 determination is included in the screening done at birth, this will identify cases of congenital hypothyroidism of central origin in 1:16,000 to 1:160,000 children.
Symptoms of normal pregnancy, like fatigue, can make it easy to overlook thyroid problems in pregnancy. [1] Thyroid hormone is vital during pregnancy. The unborn baby's brain and nervous system need thyroid hormone to develop. During the first trimester, the baby depends on the mother's supply of thyroid hormone. At 10 to 12 weeks of pregnancy ...
Postpartum thyroiditis refers to thyroid dysfunction occurring in the first 12 months after pregnancy [1] and may involve hyperthyroidism, hypothyroidism or the two sequentially. According to the National Institute of Health, postpartum thyroiditis affects about 8% of pregnancies. [ 2 ]
TSH (with a half-life of about an hour) stimulates the thyroid gland to secrete the hormone thyroxine (T 4), which has only a slight effect on metabolism. T 4 is converted to triiodothyronine (T 3), which is the active hormone that stimulates metabolism. About 80% of this conversion is in the liver and other organs, and 20% in the thyroid itself.