16 responses to “Management of maternal thyroid disease in pregnancy”

  1. I usually recheck my patient’s TSH 6-8 weeks after dose changes and readjust dosing accordingly. With pregnant patients, the recommendation to check TSH every 4-8 weeks makes it difficult to monitor and administer proper dose changes.

  2. I’ll add TSH to screening tests in ER

  3. very helpful. I noticed in the section about how to increase medications, it states to increase medication by two pills per week post-pregnancy. Is this based on a pill being 12.5mcg or are we attempting to increase dose by 1.5 times?

  4. I will add anti-TPO to P/Nblood work.

  5. Very informative and helpful article.

  6. useful

  7. very useful

  8. great reminder of not forgetting such basic prenatal concerns as TSH.
    I will now tend to screen whereas previously I was not doing so.

  9. iliac to have more specific details of the treatment and the possible side effects that we have to watch out for.

  10. Very helpful guideline in managing hypothyroidism in pregnancy.I will consider adding TSH as a screening test in the prenatal workup

  11. I was ordering TSH with every prenatal blood work until recently had an abnormal low TSH ( hyperthyroid range) .I discussed this with perinatalogist who discouraged me from regular TSH checking in pregnancy unless pt was already diagnosed with thyroid abnormality prior to getting pregnant .Please advise with relevant links to support .
    Thanks
    Neetu

  12. I was screening but not as frequently as suggested. I will definitely increase the number of times I screen throughout the pregnancy.

  13. I check TSH b/4 pregnaancy in all planned pregnanacies and in known hypothyroid patient along with other first prenatal lab tests.

  14. I have not been routinely doing TSh as part of PN work up but may consider it. I do in patients having more than 1 miscarriage. The hint on ruotinely increasing dose by 2 polls per week is helpfull.

  15. this is the ACOG guideline
    ubclinical hypothyroidism is diagnosed in asymptomatic women when the thyroid-stimulating hormone level is elevated and the free thyroxine level is within the reference range. Thyroid hormones, specifically thyroxine, are essential for normal fetal brain development. However, data indicating fetal benefit from thyroxine supplementation in pregnant women with subclinical hypothyroidism currently are not available. Based on current literature, thyroid testing in pregnancy should be performed on symptomatic women and those with a personal history of thyroid disease or other medical conditions associated with thyroid disease (eg, diabetes mellitus). Without evidence that identification and treatment of pregnant women with subclinical hypothyroidism improves maternal or infant outcomes, routine screening for subclinical hypothyroidism currently is not recommended.

  16. I have routinely done the TSH on followed them accordingly . Increasing the medication is something learnt,

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