Hyperthyroidism: Difference between revisions

Recognizing and evaluating hyperthyroidism in pregnancy is a diagnostic challenge.<ref>{{cite journal | vauthors = Fumarola A, Di Fiore A, Dainelli M, Grani G, Carbotta G, Calvanese A | title = Therapy of hyperthyroidism in pregnancy and breastfeeding | journal = Obstetrical & Gynecological Survey | volume = 66 | issue = 6 | pages = 378–385 | date = June 2011 | pmid = 21851752 | doi = 10.1097/ogx.0b013e31822c6388 | s2cid = 28728514 }}</ref> Thyroid hormones are naturallycommonly 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.<ref name="Lee 2023" /> Thyroid function generally normalizes in by the second trimester without treatment.<ref>{{cite journal | vauthors = Tan JY, Loh KC, Yeo GS, Chee YC | title = Transient hyperthyroidism of hyperemesis gravidarum | journal = BJOG | volume = 109 | issue = 6 | pages = 683–688 | date = June 2002 | pmid = 12118648 | doi = 10.1111/j.1471-0528.2002.01223.x | s2cid = 34693980 }}</ref>{{Medical citation needed|date=September 2022}} Hyperthyroidism must also be distinguished from gestational transient thyrotoxicosis; as it can increase the risk of complications for mother and child.<ref name = "Moleti_2019">{{cite journal | vauthors = Moleti M, Di Mauro M, Sturniolo G, Russo M, Vermiglio F | title = Hyperthyroidism in the pregnant woman: Maternal and fetal aspects | journal = Journal of Clinical & Translational Endocrinology | volume = 16 | pages = 100190 | date = June 2019 | pmid = 31049292 | pmc = 6484219 | doi = 10.1016/j.jcte.2019.100190 }}</ref> Such risks include pregnancy-related hypertension, pregnancy loss, low-birth weight, [[pre-eclampsia]], [[preterm]] delivery, still birth and behavioral disorders later in the child's life.<ref name="Lee 2023" /><ref>{{Cite journal | vauthors = Krassas GE |date=2010-10-01 |title=Thyroid Function and Human Reproductive Health |url=https://academic.oup.com/edrv/article/31/5/702/2354820 |access-date=2022-05-31 |journal=Endocrine Reviews |series=Volume 31, Issue 5 |volume=31 |issue=5 |pages=702–755 |doi=10.1210/er.2009-0041|pmid=20573783 }}</ref><ref name = "Moleti_2019" /><ref>{{cite journal | vauthors = Andersen SL, Andersen S, Vestergaard P, Olsen J | title = Maternal Thyroid Function in Early Pregnancy and Child Neurodevelopmental Disorders: A Danish Nationwide Case-Cohort Study | journal = Thyroid | volume = 28 | issue = 4 | pages = 537–546 | date = April 2018 | pmid = 29584590 | doi = 10.1089/thy.2017.0425 }}</ref> Nonetheless, high maternal FT4 levels during pregnancy have been associated with impaired brain developmental outcomes of the offspring and this was independent of for example hCG levels.<ref>{{cite journal | vauthors = Korevaar TI, Muetzel R, Medici M, Chaker L, Jaddoe VW, de Rijke YB, Steegers EA, Visser TJ, White T, Tiemeier H, Peeters RP | display-authors = 6 | title = Association of maternal thyroid function during early pregnancy with offspring IQ and brain morphology in childhood: a population-based prospective cohort study | journal = The Lancet. Diabetes & Endocrinology | volume = 4 | issue = 1 | pages = 35–43 | date = January 2016 | pmid = 26497402 | doi = 10.1016/S2213-8587(15)00327-7 | hdl = 1765/79096 }}</ref>