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Interpretation of in-vitro thyroid function tests during pregnancy.

S C Smith, A M Bold

    British Journal of Obstetrics and Gynaecology
    |June 1, 1983
    PubMed
    Summary
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    Interpreting pregnancy thyroid function tests is complex. This study monitored thyroid hormones, finding changes in thyroxine and TBG but stable TSH, providing trimester-specific reference ranges.

    Area of Science:

    • Endocrinology
    • Reproductive Medicine
    • Clinical Chemistry

    Background:

    • Interpreting in-vitro thyroid function tests during pregnancy is challenging due to hormonal fluctuations.
    • Oestrogen's effect on thyroid binding globulin (TBG) significantly impacts thyroid hormone measurements.

    Purpose of the Study:

    • To clarify thyroid hormone interpretation during pregnancy.
    • To establish trimester-specific reference ranges for key thyroid hormones.

    Main Methods:

    • Serum concentrations of total thyroxine (T4), free T4, TBG, T4/TBG ratio, tri-iodothyronine (T3), and TSH were measured.
    • Hormone levels were assessed throughout pregnancy, with specific attention to changes by 20 weeks and across trimesters.

    Main Results:

    Related Experiment Videos

    • Total T4 and TBG concentrations increased above non-pregnant ranges by 20 weeks.
    • The T4/TBG ratio decreased to hypothyroid levels by 20 weeks.
    • Free T4 levels were lower in the third trimester, though few subjects exhibited hypothyroid values; TSH remained stable throughout pregnancy.

    Conclusions:

    • Pregnancy significantly alters thyroid hormone levels, necessitating trimester-specific interpretation.
    • Established reference ranges are crucial for accurate diagnosis and management of thyroid function during gestation.