Endocrinology in pregnancy

2021 ◽  
pp. 469-498
Author(s):  
Catherine Williamson ◽  
Rebecca Scott
Keyword(s):  
Thyroid Cancer ◽  
Calcium Metabolism ◽  
Thyroid Dysfunction ◽  
Hyperemesis Gravidarum ◽  
Post Partum ◽  
Endocrine System ◽  
Thyroid Disorders ◽  
Fetal Thyroid ◽  
Maternal Thyroid ◽  
In Pregnancy

This chapter covers both the normal and abnormal changes to the endocrine system during pregnancy. It begins with the thyroid in pregnancy, covering maternal hyperthyroidism, hyperemesis gravidarum, overt and subclinical maternal hypothyroidism, post-partum thyroid dysfunction, and fetal thyroid diseases owing to maternal thyroid disorders. Calcium metabolism, thyroid cancer, hypoparathyroidism, and lactation associated osteoporosis. Secondly, the pituitary gland in pregnancy is focused on, covering prolactinoma, Cushing’s Syndrome, acromegaly, non-functioning pituitary adenoma, hypopituitarism, and Diabetes Insipidus. Pre-existing adrenal disorders during pregnancy and alterations to management are also included.

scholarly journals EFEKTIVITAS PEMBERIAN PISANG AMBON DAN VITAMIN B UNTUK MENURUNKAN HIPEREMESIS GRAVIDARUM DI BPM ENDAH BEKTI

2018 ◽  
Vol 7 (1) ◽  
pp. 17-21
Author(s):  
Elvika Fit Ari Shanti ◽  
Liberty Barokah ◽  
Budi Rahayu
Keyword(s):  
Pregnant Women ◽  
Vitamin B6 ◽  
Hyperemesis Gravidarum ◽  
Post Partum ◽  
Endocrine System ◽  
First Trimester ◽  
The Other ◽  
Vitamin B ◽  
Difference Test ◽  
In Pregnancy

Background: Endocrine system changes during pregnancy are important to keep the pregnancy, fetal growth and post partum recovery. Around 50-90% of pregnant women experience vomit and nausea. To solve those problems, ‘pisang ambon’ (Musa paradisiacal) consumption is one of choices because of its flavonoid and vitamin B6 which can overcome vomit and nausea in pregnancy. Objective: The aim of this research was to identify the effectiveness between pisang ambon (Musa paradisiacal) consumption and vitamin B6 to reduce hyperemesis gravidarum in BPM Endah Bekti. Methods: A quasy experimental design with two-group posttest only was assigned to 20 pregnant women on their first trimester. First ten sample was given vitamin B6 and the other ten sample were given vitamin B6 plus pisang ambon. Data were then analyzed using two independent mean difference test. Results: The result shows that in vitamin B6 consumption for hyperemesis gravidarum in 10% pregnant women were in the effective category. While in the pisang ambon consumption shows 100% of pregnant women are in the effective category. Conclusion: There is difference in effectiveness between vitamin B6 and pisang ambon consumption to overcome hyperemesis gravidarum (p=0,003<α).   Keywords: Hiperemesis gravidarum, vitamin B6, Pisang ambon

scholarly journals The study of maternal and fetal outcome in pregnant women with thyroid disorders

2017 ◽  
Vol 6 (8) ◽  
pp. 3507 ◽  
Author(s):  
Sreelatha S. ◽  
Seema Nadagoudar ◽  
Asha Devi L.
Keyword(s):  
Pregnant Women ◽  
Thyroid Dysfunction ◽  
Post Partum ◽  
Perinatal Outcomes ◽  
Fetal Outcome ◽  
Endocrine Disorders ◽  
Thyroid Disorders ◽  
Thyroid Disorder ◽  
Neonatal Hypothyroidism ◽  
In Pregnancy

Background: Thyroid disorders are among the common endocrine disorders in pregnant women after diabetes mellitus. Several changes are observed in maternal thyroid function during pregnancy and failure to adapt to these physiological changes results in thyroid dysfunction. It is well established that not only overt, but subclinical thyroid dysfunction also has adverse effect on mother and the fetus, like miscarriages, preterm delivery, preeclampsia, eclampsia, polihydromnios, placental abruption, post-partum haemorrhage, low birth weight, neonatal hypothyroidism. Decreased availability of thyroid hormones may also impair neurological and intellectual development of foetus. With this background, we are conducting a study to know the effect of thyroid disorders on pregnancy and its maternal and the fetal outcome.Methods: The present study was conducted in ESI Hospital Rajaji Nagar, Bangalore. It is a prospective study which involved 100 patients diagnosed to have thyroid disorder during their antenatal checkup in the first trimister. It also includes known cases of thyroid disorder. TSH level was estimated. If it is deranged, then FT3 and FT4 levels estimated. Patients were managed accordingly and followed till delivery. Their obstetric and perinatal outcomes were noted.Results: In our study out of 100 cases, 96 cases are subclinical hypohyroid and 4 cases are subclinical hyperthyroid. Subclinical hypothyroidism in pregnancy are associated with abortions (2.1%), Anaemia (4.20%), PIH (14.7%), GDM (4.2%), Preterm labour (3.1%), oligohydromnios (16.67%), Lscs (22.9%), PPH (6.3%), LBW (21.9%), Hyperbilirubinemia (9.4%), NICU admission (14.6%), Which are co-relatine with other studies and hyperthyroid cases in our study were not sufficient for outcome analysis.Conclusions: Thyroid disorders in pregnancy have adverse effects on maternal and fetal outcome emphasizing the importance of routine antenatal thyroid screening.

scholarly journals EFEKTIVITAS PEMBERIAN PISANG AMBON DAN VITAMIN B UNTUK MENURUNKAN HIPEREMESIS GRAVIDARUM DI BPM ENDAH BEKTI

2019 ◽  
Vol 7 (1) ◽  
pp. 17-21
Author(s):  
Elvika Fit Ari Shanti ◽  
Liberty Barokah ◽  
Budi Rahayu
Keyword(s):  
Pregnant Women ◽  
Vitamin B6 ◽  
Hyperemesis Gravidarum ◽  
Post Partum ◽  
Endocrine System ◽  
First Trimester ◽  
The Other ◽  
Vitamin B ◽  
Difference Test ◽  
In Pregnancy

Background: Endocrine system changes during pregnancy are important to keep the pregnancy, fetal growth and post partum recovery. Around 50-90% of pregnant women experience vomit and nausea. To solve those problems, ‘pisang ambon’ (Musa paradisiacal) consumption is one of choices because of its flavonoid and vitamin B6 which can overcome vomit and nausea in pregnancy. Objective: The aim of this research was to identify the effectiveness between pisang ambon (Musa paradisiacal) consumption and vitamin B6 to reduce hyperemesis gravidarum in BPM Endah Bekti. Methods: A quasy experimental design with two-group posttest only was assigned to 20 pregnant women on their first trimester. First ten sample was given vitamin B6 and the other ten sample were given vitamin B6 plus pisang ambon. Data were then analyzed using two independent mean difference test. Results: The result shows that in vitamin B6 consumption for hyperemesis gravidarum in 10% pregnant women were in the effective category. While in the pisang ambon consumption shows 100% of pregnant women are in the effective category. Conclusion: There is difference in effectiveness between vitamin B6 and pisang ambon consumption to overcome hyperemesis gravidarum (p=0,003<α). Keywords: Hiperemesis gravidarum, vitamin B6, Pisang ambon

Endocrine disorders in pregnancy

2018 ◽  
pp. 283-296
Author(s):  
Helen E. Turner ◽  
Richard Eastell ◽  
Ashley Grossman
Keyword(s):  
Thyroid Hormone ◽  
Hyperemesis Gravidarum ◽  
Post Partum ◽  
Management Strategies ◽  
Normal Pregnancy ◽  
Endocrine Disorders ◽  
Pituitary Diseases ◽  
Pregnant State ◽  
Pituitary Adrenal Axis ◽  
In Pregnancy

This chapter discusses thyroid, adrenal, and pituitary diseases that occur during pregnancy. A series of changes in thyroid hormone economy take place in normal pregnancy. As a result of these changes, thyroid hormone levels in pregnancy differ from those in the non-pregnant state. This chapter includes a description of normal thyroid physiology and thyroid pathophysiology, including hyperemesis gravidarum, post-partum thyroiditis, hypothyroidism, and hyperthyroidism. Changes in the hypothalamo-pituitary–adrenal axis during normal and abnormal pregnancies are also described, with syndromes such as Cushing’s syndrome and Addison’s disease listed. Finally, pituitary adenomas in pregnancy, and their respective features and management strategies, are listed, including acromegaly, hypopituitarism, TSH-secreting adenomas, and prolactinoma.

scholarly journals Thyroid disorder in pregnancy and postpartum with neonatal outcome a study in tertiary care centre

2019 ◽  
Vol 8 (5) ◽  
pp. 1795
Author(s):  
Bharati Das ◽  
Puspanjali Khuntia
Keyword(s):  
Thyroid Function ◽  
Post Partum ◽  
Tertiary Care ◽  
Thyroid Function Test ◽  
Thyroid Disorders ◽  
Thyroid Disorder ◽  
New Born ◽  
Pregnancy And Postpartum ◽  
Function Test ◽  
In Pregnancy

Background: Thyroid disorders are well known entity in pregnancy. Both mother and baby have to suffer from the consequences.  Lot of works has been done and many guidelines too came out over the years but what is actual understanding of the disease process by the mothers about themselves and for their babies especially in developing country like India remained uncovered. This has been analysed in present study.Methods: It is a prospective observational study done in the post-partum programmed department of SCB medical college and hospital, a tertiary care center in eastern part of India for 3 years period. Thyroid dysfunction of the mothers and new born screening of thyroid function of their babies has been assessed.Results: During this period total no of the babies along with their mothers were evaluated were 3762. Total no of thyroid disorders detected in 85 (2.25%) of mothers, among which hypothyroidism in 79 (2.09%) and hyperthyroidism in 6 (0.16%) were found. From total 85 cases, 79 (93%) mothers were hypothyroid   and 6 (7%) were hyperthyroid. Among the hypothyroid mothers 32 (40.5%) were diagnosed before present pregnancy and (59.5%) were diagnosed during pregnancy. In the babies of hypothyroid mother, new born screening for thyroid function was done only in 14 (17.7%) cases between 5-10 days.Conclusions: Thyroid screening should be done in pregnancy as universal screening instead of high-risk cases. Documentation and interdepartmental coordination are very much essential in thyroid disorders for further decision by the physician for necessity of continuation of treatment and thyroid function test in the post-partum period for the mothers and its long-term consequences. It also guides the neonatologist or pediatrician doing thyroid function test of their babies. Ideally All newborns should be screened for congenital hypothyroidism as a part of new born screening (NBS) programmed. Effective communication with the mother and the family is very much essential for monitoring and treatment of both mother and the baby.

scholarly journals Screening for Maternal Thyroid Dysfunction in Pregnancy: A Review of the Clinical Evidence and Current Guidelines

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Donny L. F. Chang ◽  
Elizabeth N. Pearce
Keyword(s):  
Thyroid Dysfunction ◽  
Clinical Evidence ◽  
Thyroid Autoimmunity ◽  
Overt Hypothyroidism ◽  
Ongoing Debate ◽  
History Of ◽  
Maternal Thyroid ◽  
Current Guidelines ◽  
Levothyroxine Treatment ◽  
In Pregnancy

Observational studies have demonstrated that maternal thyroid dysfunction and thyroid autoimmunity in pregnancy may be associated with adverse obstetric and fetal outcomes. Treatment of overt maternal hyperthyroidism and overt hypothyroidism clearly improves outcomes. To date there is limited evidence that levothyroxine treatment of pregnant women with subclinical hypothyroidism, isolated hypothyroxinemia, or thyroid autoimmunity is beneficial. Therefore, there is ongoing debate regarding the need for universal screening for thyroid dysfunction during pregnancy. Current guidelines differ; some recommend an aggressive case-finding approach, whereas others advocate testing only symptomatic women or those with a personal history of thyroid disease or other associated medical conditions.

scholarly journals THYROID FUNCTION IN PREGNANCY: MATERNAL AND FETAL OUTCOMES WITH HYPOTHYROIDISM AND SUBCLINICAL THYROID DYSFUNCTION

2011 ◽  
Vol 22 (3) ◽  
pp. 169-187
Author(s):  
NEIL K VANES ◽  
JOHN H LAZARUS ◽  
SHIAO-Y CHAN
Keyword(s):  
Thyroid Hormones ◽  
Pregnant Women ◽  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Thyroid Disorders ◽  
Thyroid Function Tests ◽  
Fetal Outcomes ◽  
Function Tests ◽  
Maternal Wellbeing ◽  
In Pregnancy

Thyroid hormones are important in the development of the fetus and the placenta as well as in maintaining maternal wellbeing. Thyroid disorders are common in the population as a whole, particularly in women, and therefore are common during pregnancy and the puerperium. Biochemical derangement of thyroid function tests are present in approximately 2.5–5% of pregnant women.

Hyperemesis Gravidarum and Thyrotoxicosis — A Diagnostic and Therapeutic Problem

1989 ◽  
Vol 34 (3) ◽  
pp. 472-473 ◽  
Author(s):  
J.A. Thomson ◽  
R. Wilson ◽  
C.G. Gray ◽  
A.C.A. Glen ◽  
D. Mack
Keyword(s):  
Early Pregnancy ◽  
Thyroid Dysfunction ◽  
Hyperemesis Gravidarum ◽  
First Trimester ◽  
Antithyroid Therapy ◽  
Spontaneous Improvement ◽  
Therapeutic Problem ◽  
Uneventful Pregnancy ◽  
In Pregnancy

We report a case of hyperemesis gravidarum complicated by thyrotoxicosis which was managed conservatively during pregnancy. Problems of diagnosing mild thyrotoxicosis in pregnancy are discussed. Although no specific antithyroid therapy was given, the patient had an uneventful pregnancy after the first trimester. Neither she nor her baby exhibited any subsequent features of thyroid dysfunction. This suggests that treatment of thyrotoxicosis in early pregnancy is not always required because of the spontaneous improvement which is likely to occur as pregnancy progresses.

scholarly journals Study of implications of thyroid status over feto-maternal outcomes in pregnancy

2020 ◽  
Vol 9 (5) ◽  
pp. 1946
Author(s):  
Smruti Gedam ◽  
Bharat Bhushan
Keyword(s):  
Subclinical Hypothyroidism ◽  
Screening Method ◽  
Maternal Outcomes ◽  
Thyroid Disorders ◽  
Thyroid Status ◽  
Fetal Complications ◽  
Clinically Significant ◽  
Maternal Thyroid ◽  
Thyroid Profile ◽  
In Pregnancy

Background: Thyroid disorders are reported at clinically significant prevalence during pregnancy, affecting ~5% of all pregnancies. Maternal thyroid status during pregnancy purportedly affects fetal as well as maternal outcomes. The objective of present study was to analyse the relationship of thyroid status in pregnancy and various maternal and fetal outcomes.Methods: In this hospital based observational study, a total of 913 pregnant women were enrolled as per fixed criteria and all the study participants were screened for thyroid disorders. Further, they were followed up throughout pregnancy and puerperium and evaluated for various maternal and fetal complications by predefined outcome measures. The results were compared by subgroup analysis.Results: Of the 913 patients screened, 105 were diagnosed with thyroid abnormality and followed up till delivery, with newborn thyroid profile on day 7. Total 49 patients were diagnosed with anaemia (46.66%), of which 46 (43.80%) had subclinical hypothyroidism (p <0.05); along with pregnancy induced hypertension in 42 (40%) cases of which 40 (38.09%) had subclinical hypothyroidism were observed to have statistically significant associations. Intrauterine growth restriction (IUGR) (37, 35.23%) and prematurity (19, 18.1%) were the most common fetal occurrences; the association of IUGR and subclinical hypothyroidism being statically significant.Conclusions: Thyroid disorders during pregnancy are commonly associated with maternal and fetal complications and thyroid profile is recommended as universal screening method in early pregnancy to diagnose and start required treatment early.

scholarly journals Screening for Thyroid Dysfunction in Pregnancy: Is It Worthwhile?

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
John H. Lazarus
Keyword(s):  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Post Partum ◽  
Thyroid Autoimmunity ◽  
Evidence Base ◽  
Obstetric Outcomes ◽  
Increased Risk ◽  
Abruptio Placenta ◽  
Anaemia In Pregnancy ◽  
In Pregnancy

There is a high incidence of thyroid dysfunction during pregnancy resulting in adverse maternal (miscarriages, anaemia in pregnancy, preeclampsia, abruptio placenta and post-partum haemorrhage) and fetal effects (premature birth, low birth weight, increased neonatal respiratory distress) which may justify screening for thyroid function during early pregnancy with interventional levothyroxine therapy for thyroid hypofunction. There is a greater prevalence of subclinical hypothyroidism in women with delivery before 32 weeks and there is even an association between thyroid autoimmunity and adverse obstetric outcome, which is independent of thyroid function. Higher maternal TSH levels even within the normal reference range are associated with an increased risk of miscarriages, fetal and neonatal distress and preterm delivery. There are few prospective randomised trials to substantiate the benefit of screening and the recently reported CATS study did not show a benefit in child IQ at age 3 years. Nevertheless there seems to be a case for screening to prevent adverse obstetric outcomes. The clinical epidemiological evidence base does not justify universal screening at the present time. However, it is probable that more evidence will be produced which may alter this view in the future.

Sign in / Sign up

Export Citation Format

Share Document