Document Detail

Hypothyroidism in pregnancy: pre-pregnancy thyroid status influences gestational thyroxine requirements.
MedLine Citation:
PMID:  18947343     Owner:  NLM     Status:  MEDLINE    
There is considerable uncertainty about the management of hypothyroidism in pregnancy. Our aim was to establish the pattern of thyroxine dose adjustment needed and to determine the clinical reasons for these changes and the contributory factors. Of 89 pregnancies, thyroxine dose was unchanged in 50, increased (by a mean of 38 micrograms) in 34, and decreased in 5. Twenty-three percent of women who were tested in the first trimester needed an immediate increase in thyroxine. One-quarter (26%) of the women who needed a gestational increase in thyroxine dose had had a recent pre-pregnancy increase in thyroxine requirement (compared with 0% in women on static dose in pregnancy, P < 0.001). Furthermore, they did not require a decrease in thyroxine dose postpartum, suggesting a long-term need for more thyroxine rather than a transient gestational effect. None of the women who had stable doses of thyroxine during pregnancy had required recent pre-pregnancy changes in dose or needed postnatal changes. Inadequate pre-pregnancy control of thyroid function is associated with a need to increase thyroxine dosage during pregnancy.
A Kothari; J Girling
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Publication Detail:
Type:  Journal Article     Date:  2008-10-08
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  115     ISSN:  1471-0528     ISO Abbreviation:  BJOG     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-11-27     Completed Date:  2009-03-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  1704-8     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynaecology, Hillingdon Hospital NHS Trust, London, UK.
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MeSH Terms
Hypothyroidism / blood,  drug therapy*
Patient Compliance
Postnatal Care
Preconception Care
Pregnancy Complications / blood,  drug therapy*
Pregnancy Outcome
Pregnancy Trimesters / blood
Thyrotropin / metabolism
Thyroxine / administration & dosage*,  metabolism
Young Adult
Reg. No./Substance:
7488-70-2/Thyroxine; 9002-71-5/Thyrotropin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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