Endocrinopathies in PregnancyThyroid and others Drugs and the Thyroid Flashcards
Fetal thyroid follicles and thyroxine synthesis occurs at ____ weeks
10
Describe the subunits of glycoproteins
2 sub units
common alpha and distinct beta unit
Make a diagnosis and explain why
Case
* 28 female
* Presents at 23 weeks gestation
* Known asthma
* Second pregnancy
* Known Graves thryotoxicosis
* Lost to F/U at another Anc clinic
* Looks tremulous, sweaty, tachycardic, large goitre with bruit
Test results
* TSH< 0.02 miu/L
* Ft4 >60 pmol/L
* FT3 >32 pmol/L
* TBII positive or 3 iu/L
Graves
-ADD MORE DURING LEC
hyperthyroidism
How does hyperthyroidism effect pregnancy?
If inadequately treated:
- IUGR
- Low birth weight
- Preecclampsia
- Preterm delivery
- Risk of stillbirth
- Risk of miscarriage
when does the thyroid axis mature
15-20 weeks
in pregnancy is Cardiac output (CO) increased or decreased
and why
increased
-increased plasma volume
How does hCG affect the thyroid?
- HCG can bind to the TSH receptors present in thyroid tissue and act like a weak form of TSH to cause the thyroid to produce and release more T4 and T3.
what is the target group for Thyroid screening
age - 30+
Bmi - 40+
Miscarriage preterm labour
Goitre
Anti TPO
Type 1 diabetes mel
how does treating graves in a pregnant patients change
- PTU instead of carbimazole in 1st trimester - ncreased risk of congenital malformations
- No radioiodine
- Carbimazole may be option after 2nd trimester
what is Microprolactinoma
Non cancerous lesions on pituitary
can cause hypogonadism
where is growth hormone made
anterior pituitary
why do we get bitemporal haemeniopia
- compromised nasal fibres of the optic nerves in both eyes due to injuries or lesions at the optic chiasm (pituitary tumour)
why can amiodarone effect the thyroid
containing iodine
what is Hypophysitis
- inflammation of the pituitary gland
