Prospective evaluation of pregnant women with hypothyroidism: Implications for treatment

Abstract

Pregnancy is characterized by a series of maternal hormonal and metabolic changes which can affect thyroid function and the course of thyroid dysfunction in different ways. Moreover, hypothyroidism is also associated with obstetric complications and morbidity to the fetus. The aim of the present study was to evaluate the influence of hypothyroidism during the course of pregnancy and the necessity of adjusting the dose of levothyroxine. We prospectively followed 16 patients with previous diagnosis of hypothyroidism. In ten patients (62.5%) it was necessary to raise the dose of levothyroxine, with a median increase of 20.7%. One pregnancy was complicated by premature amniorrhexis and two by pre-eclampsia. The screening for congenital hypothyroidism was negative in all newborns. We conclude that it is very important to offer screening to high-risk patients who wish to become pregnant. Dose adjustment based on serum levels of thyroid-stimulating hormone (TSH) is essential. In patients in whom TSH is not measured during the first weeks of pregnancy, a good approach could be to increase the dose of replacement therapy by 20-25% to avoid hypothyroidism.

Study on the changes in TSH, TPO-Ab and other indicators due to Vitamin D deficiency in Pregnant Women with subclinical hypothyroidism in the first trimester

“…4 , 5 In addition, thyroid hormone is vital to the development of the fetal central nervous system, and subclinical hypothyroidism in the first trimester could induce irreversible damage to the fetal cranial nerve. 6 In recent years, studies have shown that vitamin D can play an important role in the occurrence and development of thyroid diseases in the first trimester by becoming involved in the regulation of IL-1, hsCRP, leptin and other cytokines. 7 , 8 …”

“…4,5 In addition, thyroid hormone is vital to the development of the fetal central nervous system, and subclinical hypothyroidism in the first trimester could induce irreversible damage to the fetal cranial nerve. 6 In recent years, studies have shown that vitamin D can play an important role in the occurrence and development of thyroid diseases in the first trimester by becoming involved in the regulation of IL-1, hsCRP, leptin and other cytokines. 7,8 The objective of the present study was to investigates the effect of vitamin D deficiency on the changes in the levels of TSH, TPO-Ab, IL-1 and hsCRP in pregnant women with subclinical hypothyroidism (hereinafter referred to as SCH) in the first trimester.…”

¿Es mandatoria la tamización de disfunción tiroidea en toda mujer en la consulta preconcepcional?: Aportes de un estudio local

“…El hipotiroidismo, aún en rango subclínico, se encuentra asociado con diversas alteraciones en el sistema cardiovascular tales como dislipidemia (1) , arterioesclerosis (2) , y falla cardiaca (3) . También se ha relacionado con alteraciones en el ciclo menstrual (4) , e infertilidad femenina (5) , así como con una mayor morbilidad perinatal, hipertensión gestacional y desprendimiento prematuro de placenta (6,7) . Por otro lado, el hipertiroidismo (franco y subclínico) se asocia con una mayor prevalencia de arritmias cardiacas (8,9) , y una menor densidad mineral ósea (10,11) .…”

“…5 Profesor Titular Departamento de Obstetricia y Ginecología, Universidad Nacional de Colombia. 6 Epidemiólogo, Instituto Nacional de Cancerología 7 Profesor Unidad de Bioquímica, Universidad Nacional de Colombia. Institución donde se realizó el trabajo: Universidad Nacional de Colombia -Sede Bogotá Autor para correspondencia: Luis Felipe Fierro Maya, correo: angelik_md@yahoo.com estadísticamente significativas entre las participantes con hipotiroidismo (franco y subclínico) y aquellas con función tiroidea normal y la presencia de síntomas clínicos.…”