Endocrine Disorders in Pregnancy Flashcards
Increase in TPO antibodies is associated with an increased risk of
placenta abruptio
What is the TSH value during the first trimester to diagnose overt hypothyroidism
> 10mIU/L
What is the DOC for hypothyroidsm during the first trimester?
Levothyroxine
What is the TSH value to diagnose subclinical hypothyroidism?
2.5 to 10mIU/L
In pregnant patients with subclinical hypothyroidism and FT4 below 5th percentile, what drug will you give?
Levothyroxine
In pregnant patients with TSH 2.5-10mIU/L and normal FT4, what is your next step?
Get a TPO antibody
If TPO negative, repeat thyroid function test in 4-8 weels
If TPO positive, start levothyroxine
In pregnant patient with TSH >2.5 with TPO, what is your next step?
Begin levothyroxine
Monitor TSH and FT4 every 4 weeks until 20 weeks
In pregnant patients with subclinical thyroidism and on levothyroxine treatment, what is the target TSH in the first trimester?
<2.5 mIU/L
In pregnant patients with subclinical thyroidism and on levothyroxine treatment, when will you obtain TSH and FT4?
Between 26 to 32 weeks
At 3rd trimester, TSH goal is <3
What are the complications of subclinical hypothyroidism?
- Miscarriage
- Placental abruption
- Preterm delovery
- Low IQ at age 7-9
What are the complications associated with TPO(+)?
- spontaneous miscarriage
- Recurrent miscarriage
- Preterm delivery
- Placental abruption
Hyperthyroidism is diagnosed if the TSH is?
<0.1 mIU/L
What is the preferred treatment for overt hyperthyroidism in the first trimester?
PTU
Methimazole is associated with choanal atresia, aplasia cutis
What is the preferred treatment for overt hyperthyroidism in the 2nd trimester?
Methimazole
Due to hepatotoxicity of PTU