Post Partum Thyroiditis/ Oxford

Question 1

When post partum thyroiditis usually occurs?

Answer 1

Usually 3- 4 months after delivery
But it can present for up to a year after delivery.

Question 2

What is the incidence of postpartum thyroiditis?

Answer 2

5- 10 %

Question 3

What are the manifestations of postpartum thyroiditis?

Answer 3

• transient hypothyroidism 40%
• hyperthyroidism 40%
• biophasic by first hypothyroidism then hyperthyroidism 20 %

Question 4

What are the symptoms of postpartum thyroiditis?

Answer 4

Many women are asymptomatic
Most symptoms are vague

Question 5

Initiation of treatment should be based on symptoms or biochemical results in post partum thyroiditis?

Answer 5

On symptoms/ some women may not require treatment.

Question 6

What is the prognosis of postpartum thyroiditis?

Answer 6

• most recover spontaneously
• permanent hypothyroidism 5% / year for antibody positive women.
• recurrence rate in future pregnancy is 70 %.

Question 7

Management of postpartum thyroiditis with hypothyroidism manifestations?

Answer 7

Thyroxin..
Treatment should be withdrawn after 6 months to check recovery.

Question 8

Management of postpartum thyroiditis with hyperthyroidism manifestations?

Answer 8

B- blockers. ( not ant thyroid drugs).
Long follow up should be with annual TFT