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Recognizing and evaluating hyperthyroidism in pregnancy is a diagnostic challenge. [58] Thyroid hormones are commonly elevated during the first trimester of pregnancy as the pregnancy hormone human chorionic gonadotropin (hCG) stimulates thyroid hormone production, in a condition known as gestational transient thyrotoxicosis. [ 8 ]
Hypothyroidism is common in pregnancy with an estimated prevalence of 2-3% and 0.3-0.5% for subclinical and overt hypothyroidism respectively. [8] Endemic iodine deficiency accounts for most hypothyroidism in pregnant women worldwide while chronic autoimmune thyroiditis is the most common cause of hypothyroidism in iodine sufficient parts of the world.
Of those women who experience hypothyroidism associated with postpartum thyroiditis, one in five will develop permanent hypothyroidism requiring lifelong treatment. Postpartum thyroiditis is believed to result from the modifications to the immune system necessary in pregnancy, and histologically is a subacute lymphocytic thyroiditis.
In the United States, autoimmune inflammation is the most common form of thyroid disease while worldwide hypothyroidism and goiter due to dietary iodine deficiency is the most common. [35] [4] According to the American Thyroid Association in 2015, approximately 20 million people in the United States alone are affected by thyroid disease.
The thyroid may enlarge slightly in healthy women during pregnancy, but not enough to be felt. These changes do not affect the pregnancy or unborn baby. Yet, untreated thyroid problems can threaten pregnancy and the growing baby. Symptoms of normal pregnancy, like fatigue, can make it easy to overlook thyroid problems in pregnancy. [1]
[7] [8] In 1926 the Japanese physician Tetsushiro Shinosaki, from Fukuoka, observed the high rate of thyroid disease in Japanese people with periodic paralysis. [ 9 ] [ 10 ] The first English-language report, in 1931, originated from Dunlap and Kepler, physicians at the Mayo Clinic ; they described the condition in a patient with features of ...
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A combination of pregnancy-exacerbated hypercoagulability and additional risk factors such as obesity and thrombophilias makes pregnant women vulnerable to thrombotic events [29] T.he prophylactic measures that include the usage of low molecular weight heparin, in fact, can significantly reduce risks associated with surgery, particularly in ...