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Management of hypothyroidism in pregnancy ppt: THYROID DISORDERS & PREGNANCY

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Lucas Cox
Monday, September 3, 2018
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  • Interestingly, many large-scale studies demonstrate that the populations of women with elevated TSH concentrations are generally exclusive from those identified with low FT4 concentrations. The most common cause of congenital hypothyroidism is thyroid dysgenesis, followed by dyshormoogenesis, resistance to TSH, disorders in hormone transport, central hypothyroidism and transient congenital hypothyroidism.

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  • This finding suggests that TT4 measurements may be superior to immunoassay measurement of FT4 measurements in pregnant women.

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Subclinical hypothyroidism. See our User Agreement and Privacy Policy. Like this presentation? Pregnant women: a.

Download with free trial. How to Treat Hypothyroidism Naturally - The most common condition related to the thyroid is hypothyroidism. We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. Start on.

Results: The revised guidelines for the management of thyroid disease in pregnancy include hyypothyroidism regarding the interpretation of thyroid function pregnancy ppt in pregnancy, iodine nutrition, thyroid autoantibodies and pregnancy complications, thyroid considerations in infertile women, hypothyroidism in pregnancy, thyrotoxicosis in pregnancy, thyroid nodules and cancer in pregnant women, fetal and neonatal considerations, thyroid hypothyroirism and lactation, screening for thyroid dysfunction in pregnancy, and directions for future research. A peak hCG level typically occurs between 7 and 11 weeks gestation This is further discussed in the ATA guidelines for the management of thyrotoxicosis Excepting the very rare scenarios noted above, serum TSH measurement remains the principal determinant of maternal thyroid status at the present time and should be used to guide treatment decisions and goals. However, despite the limitations of available interventional trials of LT4 therapy in this subclinically hypothyroid group, the data taken in aggregate appear to suggest a benefit of treatment, especially as it applies to reducing miscarriage in TPOAb-positive women. If this is negative or thyroid nodules are suspected based on clinical examination, a thyroid ultrasound should be performed to evaluate nodularity.

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Primary overt maternal hypothyroidism hypothyroudism generally defined as the presence of an elevated TSH and a decreased serum FT4 concentration during gestation, with both concentrations outside the trimester-specific reference ranges. Davies TF. Reports have also detailed the potential teratogenic effects of the antithyroid medications methimazole MMI and propylthiouracil PTU. J Clin Pathol.

No trials to date have specifically examined the effects of iodine supplementation in lactation in mildly to moderately iodine-deficient regions. As such, this study should hypothyroidism pregnancy viewed as providing important and provocative data that are worthy of further study There is a greater likelihood that dose increases will be required in those patients without functional thyroid tissue e. Competing interests of guideline task force members were regularly updated, managed, and communicated to the ATA and task force members.

Monitor serum TSH and total T4 levels 3—4 weeks after every dosage adjustment. Prevalance of eleveted TSHin pregnant womenSubclinical hypothyroidism : The following upper-normal reference ranges are recommended: 1st T: 2. Check out PowerShow. It might be Hypothyroidism, a very common phrase we hear these days affecting people in an enormous way.

  • One intriguing study reported an apparent interaction of antiphospholipid antibodies and antithyroid antibodies in the risk for recurrent pregnancy loss You can change your ad preferences anytime.

  • This is especially true if you have a thyroid disease, such as hyperthyroidism or hypothyroidism, when pregnant. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising.

  • This article has been cited by other articles in PMC.

  • The thyroxine dose should be titrated to reach a serum TSH value less than 2. These disorders are physiologically different, though both may impart a similar phenotype demonstrating elevated maternal TSH concentrations.

The latter situation is referred to as management of hypothyroidism in pregnancy ppt hypothyroxinemia. Commercially baked breads have been another major source of iodine in the United States because of the use of iodate bread conditioners Feedback and suggestions for revisions from the Chairs and panel members were obtained via e-mail, regularly scheduled teleconferences, and face-to-face meetings. Recently, attention is being focused on utility of poor maternal iron status in predicting high TSH and low total T4 concentrations during pregnancy, especially in areas of borderline iodine deficiency. Normalization of TSH concentrations throughout gestation is the goal. If you continue browsing the site, you agree to the use of cookies on this website.

This is especially true if you have a thyroid disease, such as hyperthyroidism or hypothyroidism, when pregnant. Visibility Others can see my Clipboard. Benha University Hospital, Egypt E-mail:elnashar53 hotmail. Total views 10,

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WordPress Shortcode. Fetal thyroid development does not begin until 10 to 12 ws, and then continues until term. Number of embeds 4.

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Full Name Comment goes here. No Downloads. On Slideshare 0. For previously diagnosed hypothyroid women, monitor serum TSH every 3—4 weeks during first half of pregnancy and every 6 weeks thereafter.

Hypothyroidism During pregnancy. Downloads They'll give your presentations a professional, memorable appearance - the kind of sophisticated look that today's audiences expect. Pregnant women: a. Her previous pregnancy was via Caesarean delivery because of failed induction times 3 and CPD.

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Benha University Hospital, Egypt E-mail:elnashar53 hotmail. WordPress Shortcode. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising.

  • Equilibrium dialysis and ultrafiltration are used for physical separation of serum FT4 from bound T4 prior to analysis of the dialysate or ultrafiltrate. This occurred despite the expected decrease in TPOAb titers during pregnancy

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  • The primary outcome of this trial is the live birth rate.

  • In two nonrandomized studies, neurodevelopmental outcomes were improved in children from mildly to moderately iodine-deficient areas whose mothers received iodine supplementation early in pregnancy 87 In doing so, this document represents the best effort to create a useful, practical, and accurate guideline designed to help the practicing clinician, while also stimulating future research and discovery into this important and complex arena.

  • Delivery of T4 is crucial for the developing fetal brain

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Total views 14, Thank youInstitute of Medicine Report, November Subclinical hypothyroidism. V hydrocortisone may be used in case of adrenal and pituitary

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Importantly, this larger analysis demonstrates substantial population differences in the TSH upper reference limit Table 4 1724,— Preterm birth managwment remained difficult to predict, prevent, and treat primarily because there are multiple potential causes and pathways that end in premature labor Severe OHSS, which occurs in 0. In the United States, the dietary iodine intake of individuals cannot be reliably ascertained either by patient history or by any laboratory measure.

Comments 0. Home Explore Login Signup. See our User Agreement and Privacy Policy. Show More. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Radionucleotide scanning is contraindicated during pregnancy.

Like every young woman, eager to have children and to complete her family life, she too was full of joy and anticipation. Thyroid Gland - Investigation of primary hypothyroidism Actions Shares. Repeated miscarriage 4. No Downloads. Subclinical hypothyroidism was associated with increased fetaldistress, preterm delivery,Poor vision development and neurodevelopmental delay.

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Cholestyramine is not absorbed from the gut and thus not transferred to the fetus and may moderately reduce circulating thyroid hormones by binding the hormones during their enterohepatic circulation — A special cause of thyrotoxicosis is overtreatment with or factitious intake of thyroid hormone. In women with thyroid autoimmunity, hypothyroidism may occur because of the stress of pregnancy because the ability of the thyroid to augment hormone production is compromised. Haddow et al. The maximum number of hours awarded for this Continuing Nursing Education activity is 0. Attention deficit and hyperactivity disorders in the offspring of mothers exposed to mild-moderate iodine deficiency: A possible novel iodine deficiency disorder in developed countries. Importantly, this trial did not measure urinary iodine, a potential confounder because iodine status may influence the thyroidal effects of selenium.

Management of hypothyroidism in pregnancy ppt, however, most affected patients received surgery for the abnormality Competing interests of guideline task force members were preghancy updated, managed, and communicated to the ATA and task force members. This relative excess of T3 leads to supraphysiologic maternal levels of T3 and relatively low levels of T4 Thyroid Function. The most common cause of congenital hypothyroidism is thyroid dysgenesis, followed by dyshormoogenesis, resistance to TSH, disorders in hormone transport, central hypothyroidism and transient congenital hypothyroidism.

Free hormone ppt are estimated, as total hormone levels are elevated due to changes un TBG levels. Actions Shares. Sign In. Thus, one option when pregnancy is diagnosed in a woman receiving ATD therapy for GD and who, based on clinical and biochemical findings appears to be in remission, is to withdraw ATD medication and perform repeated thyroid function testing during the first trimester of pregnancy.

Screening for thyroid disease in pregnancy. Biosynthesis, Secretion, And Transport of Thyroid hormones Iodine is the most important element in the biosynthesis of thyroid hormones. However, a subsequent case—control study including LT4-treated hypothyroid women mean serum TSH 1. Separate data from a recent prospective intervention trial in the United States support this finding

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Show More. Number of embeds 4. However, overt hyperthyroidism and hypothyroidism warrant further management. It is important to note that such studies are highly difficult to complete and often enroll subjects with great heterogeneity with regard to important study parameters. Shekar Medichelimala. As such, this study should be viewed as providing important and provocative data that are worthy of further study

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Abstract Pregnancy is a period that places great physiological stress on both the mother and the fetus. Shekar Medichelimala. A single Japanese study has suggested that relapse may be prevented by low-dose ATD during the postpartum periodbut more studies on this are needed. Iodine nutrition in Iran was sufficient

Married for eight years, she longed for her bundle of joy. Actions Shares. No notes for slide. World's Best PowerPoint Templates - CrystalGraphics offers more PowerPoint templates than anyone else in the world, with over 4 million to choose from. Physiological changes of thyroid during pregnancy 1.

On Slideshare 0. Download with free trial. If you continue browsing the site, you agree to the use of cookies on this website. Shares 0.

Show More. Symptoms: dyspnea, cough On Slideshare 0. For newly diagnosed hypothyroid women, initial levothyroxine dosage is based on severity of hypothyroidism.

Important to note, Japan is a high iodine intake country, and the Japanese results may not be reproducible in other countries. In conclusion, maternal hypothyroidism is a disorder with great potential to adversely affect maternal and fetal outcomes and is also associated with multiple other conditions which can affect maternal and fetal health. In doing so, this document represents the best effort to create a useful, practical, and accurate guideline designed to help the practicing clinician, while also stimulating future research and discovery into this important and complex arena. One observational study analyzing women at 12, 24, and 32 weeks of pregnancy demonstrated delayed infant neurodevelopment in women with persistent hypothyroxinemia. Likes

This is especially true if you have a thyroid disease, such as hyperthyroidism or hypothyroidism, when pregnant. On Slideshare 0. Women who had previously been diagnosed with hypothyroidism, abnormal TSH and FT4 levelsbut who do not have symptoms. Show More. No Downloads. Home Explore Login Signup. Home Explore Login Signup.

Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Total views 9, We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads.

Since the majority of pregnancy losses occur even before pregnancy is clinically recognized, pregnancy loss is a difficult study endpoint These disorders are physiologically different, though both may impart pregnancy ppt similar phenotype demonstrating elevated maternal TSH concentrations. A case—control study among women undergoing first IVF cycles found no difference in embryo quality among women with serum TSH 0. A careful history and physical examination is of utmost importance in establishing the etiology. Importantly, whether or not LT4 treatment increases the likelihood of conception in subclinically hypothyroid women not undergoing ART has not been studied in controlled trials. Toggle navigation.

Boasting an impressive range of designs, they will support your presentations with inspiring background photos or videos that support your themes, set the right mood, enhance your credibility and inspire your audiences. Subclinical hypothyroidism. Serum TSH should be monitored throughout pregnancy in all antithyroid antibody—positive women 3. Shares 0. Upcoming SlideShare. Like Liked. You can change your ad preferences anytime.

Barker hypothesis - low birthweight associated with increased risk managemeht diabetes, hypertension, Serum TSH should be monitored throughout pregnancy in all antithyroid antibody—positive women 3. See our Privacy Policy and User Agreement for details. We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads.

Jounal of Thyroid disorders. It's FREE! Do you have PowerPoint slides to share? No notes for slide. Hypothyroid :may require treatment and some significant rate of residual hypothyroidism Recommend: maintain thyroxine until childbearing is complete, with an attempt to wean off medication 1 year after the last delivery

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Am J Obstet Gynecol. Maternal thyroid management of hypothyroidism in pregnancy ppt has also been linked to hypothyroidims depressionand to neonatal respiratory distress syndrome If the mother has had thyroid ablation or surgery she may still be TRAb positive, and antibodies may cause fetal hyperthyroidism via passage through the placenta. Therefore, lactating women also have increased dietary iodine requirements Evaluation of serum TSH concentration is recommended for all women seeking care for infertility. Overtreatment should be avoided because of the possibility of inducing fetal goiter and or fetal hypothyroidism Recommend initiating levothyroxine therapy in women with antithyroid antibodies before pregnancy, if TSH level is greater than 2.

Presentation on theme: "THYROID DISORDERS & PREGNANCY"— Presentation transcript:

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All the women identified to have hypothyroidism received levothyroxine replacement. Once, the outcome data from this study filters in, it may perhaps give us a better understanding to the contentious issue of universal screening vs. Whereas it is customary for manufacturers to suggest that laboratories establish their own reference range for such a test, this suggestion is frequently impractical for FT4 assessment because it is especially difficult to recruit subjects with specific conditions such as pregnancy from which to independently establish method- and trimester-specific reference ranges. Nonetheless, to provide guidance to all patients and clinicians, the panel recommends use of the following trimester-specific ranges and cutoffs when local assessments are not available. It is important to note that such studies are highly difficult to complete and often enroll subjects with great heterogeneity with regard to important study parameters. In a case—control study, Lata et al.

Cancel Save. Be the first to comment Login to see the comments. Start on. Home Explore Login Signup. Medical Disorders of Pregnancy You just clipped your first slide! Help Preferences Sign up Log in.

However, a recent retrospective study examined IVF outcomes in women without known thyroid disease and concluded that the presence of prepregnancy thyroid autoimmunity did not affect pregnancy rates, live birth rates, or pregnancy loss rates Preynancy the prevalence and potential dangers detailed above, many have suggested universally evaluating thyroid function in all women either before or during pregnancy. Many studies have stratified the risk imparted by hypothyroidism according to TPOAb status and consistently show that this risk is higher in TPOAb-positive women Subsequently, several other types of congenital malformations have been associated with MMI use. But T3 and free T3 levels do not rise to adult levelsas placental type III deiodinase converts most fetal T4 to reverse T3; the fetal brain which has elevated levels of type II deiodinase, is an exception.

Preterm deliveries are defined as those occurring before 37 weeks gestation. Nonetheless, available data confirm the benefits of treating severe hypothyroidism during pregnancy. No Downloads. Monitor serum TSH and total T4 levels 3—4 weeks after every dosage adjustment.

Why not share! Detection of thyroid dysfunction in early pregnancy: Universal screening or targeted high-risk case finding? A peak hCG level typically occurs between 7 and 11 weeks gestation ObG Library Hysteroscopy Fertility. This assay technology, unfortunately, is currently not widely available due to high instrument and operating costs.

World's Best PowerPoint Templates - CrystalGraphics hypothydoidism more PowerPoint templates than anyone else in the world, with over 4 million to choose from. Jounal of Thyroid disorders. Insufficient evidence to recommend universalscreening for thyroid disease in pregnant women Women who had previously been diagnosed with hypothyroidism, abnormal TSH and FT4 levelsbut who do not have symptoms. Clipping is a handy way to collect important slides you want to go back to later. Embed Size px.

For these reasons, the risk-to-benefit comparison does not presently support routine selenium supplementation of TPOAb-positive women during management of hypothyroidism in pregnancy ppt. To use this website, hypothyroidiam must agree to our Privacy Policyincluding cookie policy. Feedback and suggestions were formally discussed by the panel, and revisions were made to the manuscript prior to journal submission. No Downloads. Clipping is a handy way to collect important slides you want to go back to later.

Finally, Allan hypothyrlidism al. On Slideshare 0. In an management of hypothyroidism in pregnancy ppt area iodized salt intake before pregnancy did improve maternal thyroid function; no difference in child neurodevelopment was noted 54but improvement has been noted in other studies J Pediatr. What remains uncertain is the nuanced understanding of how this risk is reduced or abated as the extent of maternal hypothyroidism is normalized or other variables are modified.

The authors found an pregnandy risk of pregnancy complications pregnancy loss, preterm delivery, and placental abruption in relation to maternal subclinical hypothyroidism during early pregnancy, although subclinical hypothyroidism was variably defined across studies Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. These data provide the basis for recommending adjustments of LT4 dosage when affected women become pregnant and also for the timing of follow-up intervals for TSH in treated patients. Feedback and suggestions for revisions from the Chairs and panel members were obtained via e-mail, regularly scheduled teleconferences, and face-to-face meetings. Maternal iodine supplementation in severely iodine-deficient areas also decreases rates of stillbirth and neonatal and infant mortality 90 Hypothyroidism During pregnancy 1. Indian J Endocrinol Metab.

Williams textbook of Gynaecology and Obstetrics 3. Subclinical hypothyroidism. Barker hypothesis - low birthweight associated with increased risk of diabetes, hypertension, And, best of all, most of its cool features are free and easy to use. See our Privacy Policy and User Agreement for details.

The following upper-normal reference ranges are recommended: 1st T: 2. Boasting an impressive range management of hypothyroidism in pregnancy ppt designs, they will support your presentations with inspiring background photos or videos that support your themes, set the right mood, enhance your credibility and inspire your audiences. Barker hypothesis - low birthweight associated with increased risk of diabetes, hypertension, Toggle navigation. It might be Hypothyroidism, a very common phrase we hear these days affecting people in an enormous way.

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Cholestyramine is not absorbed from the gut and thus not transferred to the fetus management of hypothyroidism in pregnancy ppt may moderately reduce circulating thyroid hormones by binding the hormones during their enterohepatic circulation — Subsequent studies have shown similar impact on children born to women with isolated hypothyroxinemia, 19, —, As a general rule, the smallest possible dose of ATDs should be used whenever possible. Actions Shares. The prevalence of hypothyroidism during pregnancy is estimated to be 0.

We'll even convert your presentations and slide management of hypothyroidism in pregnancy ppt into the universal Flash format with all their original multimedia glory, including animation, 2D and 3D transition effects, embedded music or other audio, or even video embedded in slides. We can help you find more about effective and reliable natural hypothyroidism treatment. Like this presentation? Congenital cretinism: Growth failure, mental retardation, and other neuropsychologic deficits including deaf-mutism. Help Preferences Sign up Log in.

Among kanagement with baseline TSH values 2. This debate has raged since the identification of hypothyroidism as a cause of maternal and fetal distress. In this cohort of pregnant women pregnancy ppt overt hypothyroidism, the risk of child loss increased with higher levels of maternal TSH, although results should be interpreted with caution given the very small number of 27 cases studied as well as the heterogeneity of the study's endpoint. This effect was augmented by the presence of TPOAb positivity. Try out PMC Labs and tell us what you think.

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