Thyroid Disorders in the Perinatal Period

Upon completion of this course, the learner will be able to:

• Discuss the role of thyroid hormones in the body
• Explain the role of maternal thyroid in fetal development (low maternal thyroid leads to irreversible cognitive development deficits and increases risk of neurodevelopmental disorders)
• Explain the interplay between thyroid and stress (the H-P-T axis is stress sensitive and may be involved in stress regulation systems in the brain)
• Explain the hormonal sequence leading to the production of thyroid hormones
• Define TRH, TSH, T4, T3, TBG
• Describe normal range lab values for TSH, T4 in a non-pregnant woman
• Explain the impact of estrogen and of hCG on thyroid production
• Discuss how pregnancy changes TSH and T4 values
• Define hypothyroidism and subclinical hypothyroidism
• Differentiate subclinical hypothyroidism from clinical hypothyroidism
• Differentiate “primary” from “secondary” hypothyroidism
• Define Hashimoto's Disease including cause
• Describe how Hashimoto's Disease is diagnosed, including labs
• Explain treatment of Hashimoto's Disease and how it differs from other hypothyroid treatments 
• List signs, symptoms, and diagnostic criteria for subclinical hypothyroidism and for hypothyroidism
• Explain treatment of hypothyroidism
• Describe how low thyroid impacts pregnancy outcomes
• Define hyperthyroidism
• Define Graves Disease
• Explain etiology and risk factors for hyperthyroidism
• List signs, symptoms, and diagnostic criteria for hyperthyroidism
• Explain treatment of high thyroid levels
• Describe impact of hyperthyroidism on pregnancy outcomes
• Explain postpartum hyperthyroidism and describe its course and treatment. (pp thyroiditis)
• Define Sheehan's Syndrome, including its cause (pp pituitary necrosis due to severe pp hemorrhage) and prognosis (permanent and increasing destruction of gland)
• List four clinical consequences of Sheehan's Syndrome
• List four potential complications of Sheehan's Syndrome

HiveCE is an approved provider of continuing education by the California Board of Nursing, and this course meets the California Board of Nursing criteria for # hours of continuing education. Provider approved by the California Board of Registered Nursing, Provider Number 17686, for 4 contact hours. (This is widely accepted nationwide as continuing education for nurses and midwives.) More information about this provider approval may be found here.

Accepted for the NARM Midwifery Bridge Certificate under Category I.

Note: Course completion does not authorize the learner to use skills outside their scope. Please refer to your state guidelines for determining scope of care.

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