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Abdelrahman Al-daqqa
TSH
Free T4
Free
Thyroxine
Index
(FTI)
Total T4
Total T3
Resin
Triiodothyronine
Uptake
(RT3U)
**initial
screening
test**
Pregnancy
No
change
No
change
No
change
Increase
Increase
Decrease
Hyperthyroidism
Decrease
Increase
Increase
Increase
Increase
or no
change
Increase
Hypothyroidism
Increase
Decrease
Decrease
Decrease
Decrease
or no
change
Decrease
Hyperthyroidism
Occurs in 0.2% of
pregnancies; Graves
disease accounts for
95% of cases
Look for:
-Nervousness
-Tremor
-Tachycardia
-Frequent stools
-Sweating
-Heat intolerance
-Weight loss
-Goiter
-Insomnia
-Palpitations
-Hypertension
-Lid lag/lid retraction
-Pretibial myxedema
Other causes:
Treatment of Hyperthyroidism
Treatment of Hyperthyroidism
Treatment of Hyperthyroidism
Hypothyroidism
Causes:
Treatment of Hypothyroidism
ACOG Recommendations
Rheumatoid Arthritis
Effect of Pregnancy on RA
Treatment of RA in Pregnancy
Aspirin
Azathioprine
Cyclosporin
Cyclophosphamide
Methotrexate
Chlorambucil
High dose prednisone
Immune Thrombocytopenic
Purpura
ITP
Isolated thrombocytopenia
No drugs or other conditions that
may
affect platelet count
Exclude HIV, Hep C, SLE
ITP Pathology:
Gestational Thrombocytopenia
Incidence about 5%
Occurs late in pregnancy
Mild (>70 000)
No fetal neonatal
thrombocytopenia
Postpartum resolution
Myasthenia Gravis
Myasthenia Gravis:
Disease exacerbation
Miscarriage, stillbirth
IUGR, preterm labour
Neonatal lupus
Drugs and breast-feeding
Neonatal Lupus:
of