Effect of Vaginal Douching with Povidone-iodine during Early Pregnancy on the Iodine Supply to Mother and Fetus

Mahillon, I; Peers, W; Bourdoux, Pierre; Ermens, A.M.; Delange, François

doi:10.1097/00006254-199005000-00006

Cited by 3 publications

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“…The transfer of iodide from mother to foetus is also difficult to quantify, but three things need to be taken into consideration: that the iodine content of the foetal thyroid gland increases from < 2 μg at 17 weeks of gestation 27 to 300 μg at full term 28 – 31 ; that the amount of iodine in foetal T 4 at term probably averages 500 μg 32 ; and that the substitutive dose of T 4 in hypothyroid neonates is 50–75 μg per day 33 , 34 . From this, it can be estimated that the transfer of iodide from mother to foetus represents some 50 μg day − 1 .…”

Section: Requirements For Iodine During Pregnancy Lactation and The mentioning

confidence: 99%

Iodine requirements during pregnancy, lactation and the neonatal period and indicators of optimal iodine nutrition

Delange

2007

Public Health Nutr.

173

136

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Objective: This paper re-evaluates the requirements for iodine during pregnancy, lactation and the neonatal period, and formulates original proposals for the median concentrations of urinary iodine (UI) that indicate optimal iodine nutrition during these three critical periods of life. This paper also discusses the measurements that are used to explore thyroid functions during the same periods. Design: An extensive and critical review of the literature on thyroid physiopathology during the perinatal period. Setting: Human studies conducted in various regions throughout the world. Subjects: Pregnant women, lactating women, and newborns. Results: The following proposals are made after extensive review of the literature: the requirement for iodine by the mother during pregnancy is 250-300 mg day -1 ; during lactation the requirement is 225-350 mg day -1 ; and during the neonatal period the requirement of the infant is 90 mg day -1 . The median UI that indicates an optimal iodine nutrition during these three periods should be in the range of 150-230 mg day -1 . These figures are higher than recommended to date by the international agencies. Conclusions: Pregnant women and young infants, but especially the second group, are more sensitive to the effects of an iodine deficiency (ID) than the general population because their serum thyroid-stimulating hormone (TSH) and thyroxine are increased and decreased, respectively, for degrees of ID that do not seem to affect thyroid function in the general population. Systematic neonatal thyroid screening using primary TSH could be the most sensitive indicator to monitor the process of ID control.

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Section: Requirements For Iodine During Pregnancy Lactation and The mentioning

confidence: 99%

Iodine requirements during pregnancy, lactation and the neonatal period and indicators of optimal iodine nutrition

Delange

2007

Public Health Nutr.

173

136

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“…Iodized agents used as disinfectants or as contrast agents are known to have an amount of iodine that may even be thousands of times greater than that obtained from the diet ( 13 ) . Vaginal douching with povidone-iodine during pregnancy results in maternal iodine overload and increases the iodine content of amniotic fluid ( 14 ) . However, none of these studies examined the influence of iodine from the diet or from iodine supplements.…”

Section: Discussionmentioning

confidence: 99%

Amniotic fluid iodine concentrations do not vary in pregnant women with varying iodine intake

Garcı́a-Fuentes

Gallo²,

Garcia³

et al. 2008

Br J Nutr

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Iodine deficiency is an important clinical and public health problem. Its prevention begins with an adequate intake of iodine during pregnancy. International agencies recommend at least 200 mg iodine per d for pregnant women. We assessed whether iodine concentrations in the amniotic fluid of healthy pregnant women are independent of iodine intake. This cross-sectional, non-interventional study included 365 consecutive women who underwent amniocentesis to determine the fetal karyotype. The amniocentesis was performed with abdominal antisepsis using chlorhexidine. The iodine concentration was measured in urine and amniotic fluid. The study variables were the intake of iodized salt and multivitamin supplements or the prescription of a KI supplement. The mean level of urinary iodine was 139·0 (SD 94·5) mg/l and of amniotic fluid 15·81 (SD 7·09) mg/l. The women who consumed iodized salt and those who took a KI supplement had significantly higher levels of urinary iodine than those who did not (P¼ 0·01 and P¼0·004, respectively). The urinary iodine levels were not significantly different in the women who took a multivitamin supplement compared with those who did not take this supplement, independently of iodine concentration or multivitamin supplement. The concentrations of iodine in the amniotic fluid were similar, independent of the dietary iodine intake. Urine and amniotic fluid iodine concentrations were weakly correlated, although the amniotic fluid values were no higher in those women taking a KI supplement. KI prescription at recommended doses increases the iodine levels in the mother without influencing the iodine levels in the amniotic fluid. Iodine: Amniotic fluid: PregnancyAlthough marked physiological differences exist between the maternal and fetal thyroids, both systems interact through the placenta and the amniotic fluid, modulating the transfer of iodine and small but biologically important amounts of thyroid hormones from the mother to the fetus (1) . Prior to the end of the first trimester, when the fetal thyroid gland and the pituitary-thyroid axis become functional, the thyroid hormones required by the fetus are all obtained from the maternal circulation (2) .The volume and content of amniotic fluid is the result of a balance between the urine and the fetal pulmonary fluids, the amount of fluid that is reabsorbed or swallowed by the fetus (3) and transfer of water and solutes across the fetal membranes.Animal studies have demonstrated a rapid exchange between the mother and fetus and between the fetus and the amniotic fluid, suggesting that the amniotic fluid could act as an iodine reservoir for the fetus (4) . Etling et al. (5) found high levels of iodine in the amniotic fluid of women who had undergone urographic examinations with iodized contrast materials or who had been exposed to iodized agents vaginally. However, few studies have investigated the iodine concentration in the amniotic fluid of human subjects and these only examined the influence of the overload of high iodine concentrations. ...

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“…2 However, few studies have evaluated the effects of exposure to PVP-I during the first trimester of pregnancy, either on maternal thyroid metabolism or regarding the possible consequences to the embryo and fetus. 4,5 The aim of this study was to assess the effect of an application of PVP-I on urinary iodine concentrations and levels of thyroid-stimulating hormone (TSH) and free thyroxine (T 4 ) during the course of antiseptic treatment prior to uterine evacuation by dilatation and curettage in first-trimester miscarriages.…”

Section: Introductionmentioning

confidence: 99%

Use of povidone–iodine during the first trimester of pregnancy: a correct practice?

Velasco¹,

Naranjo²,

López-Pedrera³

et al. 2009

BJOG

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Povidone-iodine (PVP-I) has been widely used as an antiseptic agent during invasive procedures for prenatal diagnosis. Women have been reported of thyroid dysfunction after simple exposure to PVP-I. We studied the effect on thyroid function and urinary iodine excretion after a single topical application of PVP-I in 31 women who had a miscarriage during the first trimester of pregnancy. PVP-I is absorbed through the skin and the vaginal mucosa, resulting in a sudden increase in the urinary excretion of iodine and a short-term variation in concentrations of thyroid hormones in maternal serum. This metabolic effect could have consequences for the embryo and the fetus during crucial stages of development.

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Effect of Vaginal Douching with Povidone-iodine during Early Pregnancy on the Iodine Supply to Mother and Fetus

Cited by 3 publications

References 0 publications

Iodine requirements during pregnancy, lactation and the neonatal period and indicators of optimal iodine nutrition

Iodine requirements during pregnancy, lactation and the neonatal period and indicators of optimal iodine nutrition

Amniotic fluid iodine concentrations do not vary in pregnant women with varying iodine intake

Use of povidone–iodine during the first trimester of pregnancy: a correct practice?

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