Postpartum Management of Women Begun on Levothyroxine during Pregnancy

Stagnaro-Green, Alex

doi:10.3389/fendo.2015.00183

Cited by 18 publications

(17 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This can occur during pregnancy, when the mother might suffer from hypothyroidism, which will have adverse effects on her progeny (Stagnaro-Green 2015). Of note, up to 15% of all pregnancies are accompanied by the overt or subclinical hypothyroidism (Stagnaro-Green 2015). Our recent findings show that antenatal/early postnatal hypothyroidism significantly alters the regulation of coronary circulation by abolishing the anticontractile effect of nitric oxide (NO) (Gaynullina et al 2017).…”

Section: :2mentioning

confidence: 93%

Antenatal/early postnatal hypothyroidism alters arterial tone regulation in 2-week-old rats

Софронова

Gaynullina

Shvetsova

et al. 2017

Journal of Endocrinology

View full text Add to dashboard Cite

The mechanisms of vascular alterations resulting from early thyroid hormones deficiency are poorly understood. We tested the hypothesis that antenatal/early postnatal hypothyroidism would alter the activity of endothelial NO pathway and Rho-kinase pathway, which are specific for developing vasculature. Dams were treated with propylthiouracil (PTU, 7 ppm) in drinking water during gestation and 2 weeks after delivery, and their progeny had normal body weight but markedly reduced blood levels of thyroid hormones (ELISA). Small arteries from 2-week-old male pups were studied using wire myography, qPCR and Western blotting. Mesenteric arteries of PTU pups, compared to controls, demonstrated smaller maximum response to α-adrenergic agonist methoxamine and reduced mRNA contents of smooth muscle differentiation markers α-actin and SERCA2A. Inhibition of basal NO synthesis by l-NNA led to tonic contraction of mesenteric arteries and augmented their contractile responses to methoxamine; both l-NNA effects were impaired in PTU pups. PTU pups demonstrated lower blood level of NO metabolites compared to control group (Griess reaction). Rho-kinase inhibitor Y27632 strongly reduced mesenteric arteries responses to methoxamine in PTU pups, that was accompanied by elevated Rho-kinase content in their arteries in comparison to control ones. Unlike mesenteric, saphenous arteries of PTU pups, compared to controls, had no changes in α-actin and SERCA2A contents and in responses to l-NNA and Y27632. In conclusion, thyroid hormones deficiency suppresses the anticontractile effect of NO and potentiates the procontractile Rho-kinase effects in mesenteric arteries of 2-week-old pups. Such alterations disturb perinatal cardiovascular homeostasis and might lead to cardiovascular pathologies in adulthood.

show abstract

Section: :2mentioning

confidence: 93%

Antenatal/early postnatal hypothyroidism alters arterial tone regulation in 2-week-old rats

Софронова

Gaynullina

Shvetsova

et al. 2017

Journal of Endocrinology

View full text Add to dashboard Cite

show abstract

“…In which they have suggested higher the TSH value during pregnancy, higher the levothyroxine dose requirement during pregnancy, thyroid antibody positivity, postpartum thyroiditis will require continuation of levothyroxine in post-partum. 19 This has been observed in other studies which was done to know the natural course of subclinical hypothyroidism in post-partum period and beyond. The development of overt hypothyroidism (OH) in Haddow et al, on 10 years follow up was 64%, Shield BM et al, in their 5 year follow up was 25%and Indian study too in their 2 years follow up showed 18%.…”

Section: Hypothyroidismmentioning

confidence: 58%

Thyroid disorder in pregnancy and postpartum with neonatal outcome a study in tertiary care centre

Das¹,

Khuntia²

2019

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

Background: Thyroid disorders are well known entity in pregnancy. Both mother and baby have to suffer from the consequences. Lot of works has been done and many guidelines too came out over the years but what is actual understanding of the disease process by the mothers about themselves and for their babies especially in developing country like India remained uncovered. This has been analysed in present study.Methods: It is a prospective observational study done in the post-partum programmed department of SCB medical college and hospital, a tertiary care center in eastern part of India for 3 years period. Thyroid dysfunction of the mothers and new born screening of thyroid function of their babies has been assessed.Results: During this period total no of the babies along with their mothers were evaluated were 3762. Total no of thyroid disorders detected in 85 (2.25%) of mothers, among which hypothyroidism in 79 (2.09%) and hyperthyroidism in 6 (0.16%) were found. From total 85 cases, 79 (93%) mothers were hypothyroid and 6 (7%) were hyperthyroid. Among the hypothyroid mothers 32 (40.5%) were diagnosed before present pregnancy and (59.5%) were diagnosed during pregnancy. In the babies of hypothyroid mother, new born screening for thyroid function was done only in 14 (17.7%) cases between 5-10 days.Conclusions: Thyroid screening should be done in pregnancy as universal screening instead of high-risk cases. Documentation and interdepartmental coordination are very much essential in thyroid disorders for further decision by the physician for necessity of continuation of treatment and thyroid function test in the post-partum period for the mothers and its long-term consequences. It also guides the neonatologist or pediatrician doing thyroid function test of their babies. Ideally All newborns should be screened for congenital hypothyroidism as a part of new born screening (NBS) programmed. Effective communication with the mother and the family is very much essential for monitoring and treatment of both mother and the baby.

show abstract

“…11,12 The starting dose of thyroxine will depend on the degree of hypothyroidism, 13 the size of the patient and the presence of other medical problems. If unsure, the most important thing is to check thyroid function soon after starting therapy (e.g.…”

Section: Hypothyroidism Diagnosed During Pregnancymentioning

confidence: 99%

“…Thyroid function tests are checked within four weeks of starting therapy. 11,12 In the postpartum period the ongoing need for thyroxine needs to be reassessed. The concentrations of thyroid hormones that prompted treatment during pregnancy may be satisfactory in a non-pregnant woman.…”

Section: Antithyroid Therapymentioning

confidence: 99%