scholarly journals Thyroid dysfunction in pregnancy: practical perspective

2021 ◽  
Vol 12 (5) ◽  
pp. 316-321
Author(s):  
Saadi JS AlJadir
Keyword(s):  
Critical Period ◽  
Thyroid Dysfunction ◽  
Thyroid Status ◽  
Complex Interplay ◽  
Hemodynamic Changes ◽  
Pregnancy And Postpartum ◽  
Protein Change ◽  
Current Guidelines ◽  
In Pregnancy

Pregnancy is a complex endocrine and metabolic status in life of women, therefore role of the thyroid physiology during this period will be profoundly affected, this has been attributed to the complex interplay of Human chorionic gonadotrophin that acts as TSH receptors’ stimulant, more estrogen is produced by placenta will lead to rise in the serum level of Thyrogublin binding protein, change in iodine homeostasis, and hemodynamic changes. From 12th -16th week of pregnancy, the fetus is entirely dependent on the thyroid status of the mother, therefore any disruption in this metabolic milieu will lead to negative outcomes on both the fetus and the mother. Therefore, the current guidelines have stressed on appropriate management of thyroid dysfunction in pregnancy with particular interest on early pregnancy, a critical period for neurocognitive development, then throughout the pregnancy and postpartum period (Figure 1).

scholarly journals Posttraumatic Stress During Pregnancy and the Postpartum Period

2014 ◽  
Author(s):  
Susan Ayers ◽  
Elizabeth Ford
Keyword(s):  
Subjective Experience ◽  
Negative Impact ◽  
Post Traumatic Stress ◽  
Individual Vulnerability ◽  
Postpartum Ptsd ◽  
Pregnancy And Postpartum ◽  
Life Threatening ◽  
Post Traumatic ◽  
In Pregnancy

Research on post-traumatic stress disorder (PTSD) in pregnancy and postpartum is relatively new but clearly demonstrates the importance of recognizing and treating women with PTSD at this time. Women with PTSD in pregnancy are at greater risk of pregnancy complications and health behaviors that have a negative impact on the woman and fetus. Approximately –3% of women develop PTSD after giving birth, and rates increase for women who have preterm or stillborn infants or life-threatening complications during pregnancy or labor. Models of the etiology of postpartum PTSD focus on the interaction among individual vulnerability, risk, and protective factors during and after birth. Research shows evidence for the role of previous psychiatric problems, depression in pregnancy, severe complications during birth, support, and women’s subjective experience of birth in postpartum PTSD. Very little research has examined screening or intervention. The chapter highlights key research topics that need addressing.

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.

Influence of humoral and volume factors on altered osmoregulation of normal human pregnancy

1990 ◽  
Vol 258 (4) ◽  
pp. F900-F907 ◽  
Author(s):  
J. M. Davison ◽  
E. A. Shiells ◽  
P. R. Philips ◽  
M. D. Lindheimer
Keyword(s):  
Hypertonic Saline ◽  
Water Immersion ◽  
Plasma Osmolality ◽  
Late Pregnancy ◽  
Human Pregnancy ◽  
Pregnancy And Postpartum ◽  
Normal Human ◽  
Central Volume ◽  
In Pregnancy

These studies were designed to characterize mechanisms leading to decreased plasma osmolality (Posmol) and osmotic thresholds (T) for arginine vasopressin (AVP) release (TAVP) and thirst (Tthirst) in pregnancy. First, the influence of the pregnancy hormone, human chorionic gonadotrophin (hCG), was tested in six nonpregnant women who received hypertonic saline during the luteal phase of the menstrual cycle on two occasions (randomly allocated), once after 15,000 IU of hCG when Posmol, TAVP, and Tthirst decreased 6, 5, and 5 mosmol/kgH2O, respectively (P less than 0.01). In contrast, hCG pretreatment of males (n = 6) had no significant effect. Next, the role of decreased effective vascular volume (underfilling) was evaluated in seven women undergoing hypertonic saline infusion in the presence and absence of head-out water immersion (randomly allocated) during early and late pregnancy and postpartum. Posmol, TAVP, and Tthirst were not influenced by immersion and remained 10 mosmol/kgH2O lower in pregnancy (P less than 0.01). Central redistribution of intravascular volume consistently lowered hematocrit and rate of rise of PAVP per unit increment in Posmol (P less than 0.01). Although these data failed to support the hypothesis that the osmoregulatory change in human pregnancy is attributable to decrements in effective central volume (underfill), they do suggest that hCG may play a role.

The impact of thyroid function in women at the reproductive age: infertility, pregnancy and the postpartum period

2013 ◽  
Vol 154 (51) ◽  
pp. 2017-2023 ◽  
Author(s):  
Gábor Speer
Keyword(s):  
Clinical Practice ◽  
Drug Therapy ◽  
Practice Guidelines ◽  
Thyroid Dysfunction ◽  
Antithyroid Drug ◽  
Reproductive Age ◽  
Antithyroid Drug Therapy ◽  
Pregnancy And Postpartum ◽  
The Impact ◽  
In Pregnancy

This article reviews the management and diagnosis of thyroid dysfunction during pregnancy and postpartum, which was published by any of the endocrine societies in 2012. The author presents human data based on these clinical practice guidelines, however, there are also many unresolved questions. Especially, there are inconsistencies about screening using plasma TSH measurement. In pregnancy the main causes of hyperthyroidism are Graves’s disease and gestational transient thyrotoxicosis. Generally, gestational transient thyrotoxicosis does not require medication, whereas Graves’s disease needs antithyroid drug therapy. Postpartum thyroiditis occurs more frequently in antithyroid peroxidase-positive women, who should be screened using serum thyrotropin measurements at 6 to 12 gestation weeks and at 3 and 6 months postpartum. Because overt maternal hypothyroidism, due to autoimmune pathophysioloical mechanisms, negatively affects the fetus, timely recognition and treatment are important. The subclinical form of maternal hypothyroidism should also be treated. A link between thyroid dysfunction and infertility has been warranted. Orv. Hetil., 2013, 154(51), 2017–2023.

scholarly journals The Role of Plasma Female Sex Hormones on Gingivitis in Pregnancy: A Clinicobiochemical Study

2012 ◽  
Vol 13 (6) ◽  
pp. 760-763 ◽  
Author(s):  
Sandeep Prakash ◽  
Rashmita Nayak ◽  
Gopal Krishna Choudhury ◽  
Sumit Deshpande ◽  
KP Ashok ◽  
...  
Keyword(s):  
Sex Hormones ◽  
Oral Hygiene ◽  
Elisa Test ◽  
Female Sex ◽  
Female Sex Hormones ◽  
Hygiene Measures ◽  
Pregnancy And Postpartum ◽  
Hormonal Assay ◽  
In Pregnancy

ABSTRACT Objectives To correlate the changes in the level of female sex hormones (progesterone, estrogen) in plasma with the changes in severity of gingivitis in various trimesters of pregnancy till the postparturition. Materials and methods This study comprised of 20 pregnant women with good oral hygiene who were followed up in each trimester till 3rd month of postpartum by screening their oral hygiene status following OHI-S index by Greene and Vermillion. Clinically to correlate gingivitis, gingival index by Loe and Sillness was carried out in each trimester till postpartum. For hormonal assay, blood sampling by venipuncture was done and quantative analysis of the hormones was done by ELISA test. Results and conclusion The severity of gingivitis gradually increased and reached its peak in 3rd trimester followed by sudden decline in the severity in postpartum which correlated with gradual increase in the plasma level of progesterone and estrogen levels to reach their peak in the 3rd trimester and sudden fall after the postpartum. This study shows the role of female sex hormones in aggravating gingivitis to its peak in the 3rd trimester, even though the oral hygiene remains fairly good constantly. Clinical significance This study signifies the gingivitis status during different trimesters of pregnancy and postpartum indicating the general practitioner to take appropriate oral hygiene measures. How to cite this article Nayak R, Choudhury GK, Prakash S, Deshpande S, Ashok KP, Spoorthi BR. The Role of Plasma Female Sex Hormones on Gingivitis in Pregnancy: A Clinicobiochemical Study. J Contemp Dent Pract 2012;13(6): 760-763.

scholarly journals Social network and emotional intelligence in pregnancy and postpartum

2018 ◽  
Vol 12 (2) ◽  
pp. 164-179
Author(s):  
Jennifer L. Rode ◽  
Suzanne M. Stricklin ◽  
Stephanie Nicely
Keyword(s):  
Social Support ◽  
Emotional Intelligence ◽  
Social Network ◽  
Individual Differences ◽  
Well Being ◽  
Functional Social Support ◽  
Pregnancy And Postpartum ◽  
Perinatal Women ◽  
In Pregnancy

Although evidence supports the role of social support in perinatal women's well-being, the dynamics of these relationships remain unclear. We examined changes in social support and social network from prenatal to postpartum periods from 168 perinatal women. Individual differences in emotional intelligence (EI) were examined as moderating these changes. Results suggest that functional social support increases in postpartum while social network decreases. EI significantly moderated change in functional social support from fathers such that functional social support from a woman's father was significantly higher in women with higher EI. Changes in social network were not significantly affected by EI.

Role of dyslipidaemia and lipid peroxidation in pregnancy induced hypertension

2015 ◽  
Vol 4 (3) ◽  
pp. 205 ◽  
Author(s):  
Shikha Saxena ◽  
KV Thimmaraju ◽  
PremC Srivastava ◽  
AyazK Mallick ◽  
Biswajit Das ◽  
...  
Keyword(s):  
Lipid Peroxidation ◽  
Pregnancy Induced Hypertension ◽  
Induced Hypertension ◽  
In Pregnancy

Telmisartan in High Cardiovascular Risk Patients

2012 ◽  
Vol 8 (1) ◽  
pp. 10 ◽  
Author(s):  
Roland Asmar ◽  
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Ace Inhibitors ◽  
Angiotensin Receptor Blockers ◽  
High Cardiovascular Risk ◽  
Raas Blockade ◽  
Risk Patients ◽  
Receptor Blockers ◽  
Current Guidelines

The worldwide morbidity and mortality burden of cardiovascular disease (CVD) is overwhelming and caused by increasing life expectancy and an epidemic of risk factors, including hypertension. Therapeutic options targeting different areas of the renin–angiotensin–aldosterone system (RAAS) to disrupt pathophysiological processes along the cardiovascular continuum are available. Angiotensin-converting enzyme (ACE) inhibitors are first-line treatments for CVD and angiotensin receptor blockers (ARBs) are suitable alternatives. Both ACE inhibitors and ARBs prevent CVD by lowering blood pressure (BP). Additionally, several studies have demonstrated that RAAS blockade can reduce cardiovascular risk beyond what might be expected from BP lowering alone. However, the ARBs are not all equally effective. Telmisartan is a long-lasting ARB that effectively controls BP over the full 24-hour period. Recently, the Ongoing telmisartan alone and in combination with ramipril global endpoint trial (ONTARGET) study showed that telmisartan reduces cardiovascular events in high cardiovascular risk patients similarly to the gold standard ACE inhibitor ramipril beyond BP lowering alone, but with a better tolerability. Based on the results of the ONTARGET and Telmisartan randomized assessment study in ACE intolerant subjects with cardiovascular disease (TRANSCEND) studies, telmisartan is indicated for the reduction of cardiovascular morbidity. This article aims to review current guidelines for the management of CVD and consider key data from clinical trials and clinical practice evaluating the role of telmisartan in CVD.

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