Thyroxine requirement during pregnancy for replacement therapy of hypothyroidism
Article Abstract:
Thyroid assessment may be difficult during pregnancy because of the complex changes in thyroid function that occur during this time. There are several active thyroid preparations that are used for replacement therapy of hypothyroidism. There is no consensus of the appropriate dose of the thyroid hormone thyroxine (T4) needed for replacement during pregnancy for hypothyroid patients. Pregnant patients with hypothyroidism due to thyroidectomy, removal of the thyroid (usually for thyroid carcinoma), were studied to determine the dose requirements of thyroxine (T4) and desiccated thyroid during their pregnancies. There were eight pregnancies in six women. In four patients with five pregnancies, free T4 in the blood decreased during pregnancy but increased above the normal range after delivery. Serum thyroid-stimulating hormone (TSH) increased during pregnancy but returned to an undetectable level after delivery with one exception. The T3-to-T4 ratio, which is related to the conversion of T4 to triiodothyronine (T3), was lower in the patients treated with T4 than in normal controls, regardless of pregnancy. The ratio decreased during pregnancy and a relative deficiency of T3 during pregnancy was suspected. Replacement therapy for pregnant patients with hypothyroidism after removal of the thyroid should include an increased dose of T4. The dose of desiccated thyroid does not need to be changed. Pregnant patients with hypothyroidism due to total thyroidectomy are well suited for evaluating thyroid hormone replacement during pregnancy. Blood TSH levels should be monitored occasionally during pregnancy and the dose of T4 should be increased in cases of an elevated TSH level. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Obstetrics and Gynecology
Subject: Health
ISSN: 0029-7844
Year: 1990
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Precision of reflectance meters in screening for gestational diabetes
Article Abstract:
The accuracy and reliability of the reflectance meter test, used to screen for gestational diabetes, a condition of glucose intolerance with onset during pregnancy, was evaluated. The study investigated the possibility that inaccurate reflectance meters may affect the reliability of the blood sugar values obtained with their use. In 45.2 percent of the cases, the reflectance meter's results indicated the need for a 3-hour glucose tolerance test. By comparison, standard laboratory test results indicated a need for the tests in only 16 percent of the cases. The use of reflectance meters is not recommended, due to inaccuracy and due to the rising costs of oral glucose tolerance tests.
Publication Name: Obstetrics and Gynecology
Subject: Health
ISSN: 0029-7844
Year: 1989
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