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Resistance to thyroid hormone in pregnancy
Simi Dhingra1, Penny J D Owen, John H Lazarus
1Department of Obstetrics and Centre for Endocrine and Diabetes Sciences, University Hospital of Wales, Cardiff, UK. sdhingra@doctors.org.uk
Obstetrics and Gynecology
|August 2, 2008
Summary
Resistance to thyroid hormone in pregnancy can present with goiter. Treatment is not always necessary, and neonates are typically healthy, but careful evaluation is advised.
Area of Science:
- Endocrinology
- Reproductive Medicine
- Genetics
Background:
- Resistance to thyroid hormone (RTH) is characterized by elevated thyroid hormones with normal or elevated thyroid-stimulating hormone (TSH).
- This condition can affect thyroid function tests during pregnancy, necessitating careful management.
- RTH diagnosis is crucial for maternal and fetal well-being.
Observation:
- A case series of three pregnant women with RTH is presented.
- Two patients remained asymptomatic, while one developed a goiter with progressive TSH suppression requiring intervention.
- All neonates were born healthy with normal growth and thyroid function tests at one week.
Findings:
- Pregnancy in women with RTH can lead to goiter formation and TSH level fluctuations.
- Asymptomatic RTH does not necessitate treatment solely to normalize thyroid hormone levels during pregnancy.
- Prenatal diagnosis aids in appropriate management strategies for mother and fetus.
Implications:
- Early RTH diagnosis is vital for effective pregnancy management and avoiding unnecessary interventions.
- Goiter may be the sole clinical sign of RTH.
- Postnatal evaluation of neonates born to mothers with RTH is essential.
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