Thyroid Disorders in the Perinatal Period

Should thyroid antibodies be routinely tested for in pregnancy? 

Which postpartum thyroid condition can be deadly?

What are the safe ways to ensure adequate iodine during pregnancy? Is routine iodine supplementation safe?

If you thought you knew about thyroid but are struggling with the answers to those questions, this course is for you!

Learning Objectives:

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

Approved by MEAC for 4 hours of continuing education.

Approved by OBNM for 4 hours of continuing education (OB or general). Approval #17-491.