Thyroid and pregnancy - Clinical practice advice by Internat
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Pregnancy acts as a stress test for the thyroid gland. Pregnancy impacts the functioning of the thyroid gland profoundly and is associated with a 10%–40% increase in the size of the gland, a 50% increase in the production of thyroxine (T4) and triiodothyronine (T3), and a 50% increase in the daily requirement of iodine. These physiological changes can render a pregnant, iodine‐deficient, euthyroid woman in the first trimester hypothyroid during the later stages of pregnancy. Human chorionic gonadotropin (hCG), secreted by the placenta, also impacts thyroid function because it simulates thyroid‐stimulating hormone (TSH) activity.

The best method to assess free T4 during pregnancy is to measure T4 in the dialysate/ultrafiltrate of the serum samples employing on‐line extraction/liquid chromatography or tandem mass spectrometry. However, if these methods are unavailable, the clinician can employ any available technique, with the knowledge of its shortcomings. Notably, serum TSH is a superior indicator of thyroid function in pregnancy.

Further recommendations are given in posters attached. This list is a brief compilation of some of the key recommendations included in the article and is not exhaustive and does not constitute medical advice.

Kindly refer to the original publication here:
https://obgyn.onlinelibrary.wiley.com/doi/10.1002/ijgo.12745
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