Hypothyroidism In pregnancy/Oxford

Question 1

What is the prevalence of hypothyroidism in pregnancy?

Answer 1

1 % of pregnancies

Question 2

What are the features of hypothyroidism in pregnancy?

Answer 2

Cold intolerance
Bradycardia
Slow relaxation of tendon reflexes

Question 3

How to diagnose hypothyroidism in pregnancy? How to monitor?

Answer 3

Diagnosis: low free T4
( raised TSH is not diagnostic alone)
Monitor: TSH
( FT4 levels are normally lower in 2nd and 3rd trimester)

Question 4

What are the causes of hypothyroidism?

Answer 4

Hashimoto’s thyroiditis
Atrophic thyroiditis
Congenital absence of thyroid
Iatrogenic:
Thyroidectomy
Radioiodine
Amiodaron/ lithium/ iodine/
Antithyroid drugs
Pituitary cause (rare)

Question 5

What are the main thyroid antibodies?

Answer 5

• thyroid peroxidase autoantibodies
  TPO
• thyroglbulin antibodies TGAB
• thyroid stimulating immunoglobulin TSI

Question 6

What are the conditions that most accompanied with goitre?

Answer 6

Iodine deficiency
Hashimoto’s thyroiditis

Question 7

If AITD is diagnosed..what medical conditions should be excluded?

Answer 7

DM type 1
Vitiligo
Pernicious anaemia