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Ates F, Topaloglu ÖF, Secilmis O, Aktas G, Ozler S, Durmaz MS, Koplay M. Evaluation of the thyroid gland vascularity during pregnancy using 2-dimensional color Superb Microvascular İmaging vascularization index technique. Eur J Obstet Gynecol Reprod Biol 2024; 296:316-320. [PMID: 38518486 DOI: 10.1016/j.ejogrb.2024.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 03/04/2024] [Accepted: 03/16/2024] [Indexed: 03/24/2024]
Abstract
PURPOSE We aimed to investigate maternal thyroid parenchymal vascularity with 2-dimensional color superb microvascular imaging vascularization index (2D-cSMIVI) levels and thyroid gland volume in the first, second and third trimesters. METHODS This longitudinal prospective study was carried out with participants selected from 30 healthy asymptomatic pregnant women. Ultrasonography (US) for the thyroid gland was performed in each trimester. The vascularization index (VI) values obtained by manually drawing the contours of the thyroid parenchyma in the longutidinal plane, using the free region of interest (ROI) with 2DcSMIVI mode. VI values obtained in each trimester, thyroid hormone levels (TSH, T3, T4) and thyroid volumes were compared. RESULTS We have detected that thyroid gland vascularity increased significantly as pregnancy progresses. The mean VI values of thyroid gland in third trimester were significantly higher than first and second trimester (p < 0.001), and the mean VI values of the thyroid gland in the second trimester were significantly higher than first trimester (p < 0.001). During pregnancy, we detected the increase in VI values, TSH levels and thyroid gland volumes. CONCLUSION Maternal thyroid gland gray scale findings, parenchymal vascularization, thyroid volumes should be evaluated routinely for the healthy fetal development. 2D-cSMIVI method allows us to evaluate vascularization with quantitative numerical values objectively. We have detected that the VI values and volume of the thyroid gland increases as pregnancy progresses. In the complex situation of pregnancy process, the thyroid gland can be evaluated quantitatively with SMI method effectively.
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Affiliation(s)
- Fatih Ates
- Health Ministry of Turkish Republic, Konya City Hospital, Department of Radiology, Konya, Turkey.
| | | | - Ozlem Secilmis
- Department of Obstetrics and Gynecology, Selcuk University, Faculty of Medicine, Konya, Turkey.
| | - Görkem Aktas
- Department of Obstetrics and Gynecology, Dr. Ali Kemal Belviranli Obstetrics and Gynecology Hospital, Konya, Turkey.
| | - Sibel Ozler
- Department of Obstetrics and Gynecology, Medicana Hospital, Konya, Turkey.
| | | | - Mustafa Koplay
- Department of Radiology, Selcuk University,Konya, Turkey.
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Okuyan E, Karabay Akgul O, Tureyici L, Atac H, Cetin M, Günakan E, Karakaya F. The relationship between maternal thyroid volume, TSH levels, and Healthy Eating Index scores in BMI-matched pregnant women with hyperemesis gravidarum. J Matern Fetal Neonatal Med 2023; 36:2236270. [PMID: 37469044 DOI: 10.1080/14767058.2023.2236270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 05/08/2023] [Accepted: 07/08/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVE The aim is to investigate the relationship between thyroid volume measurement and healthy nutrition questionnaire scoring in pregnant women diagnosed with hyperemesis gravidarum (HEG). METHODS One hundred and fifty pregnant women with a BMI of 15-25 kg/m2 and between the ages of 17 and 42 who were diagnosed with HEG at 11-14 weeks of gestation were included in the study. Patients with a history of any disease, drug use, and previously diagnosed eating disorders were excluded. All patients were subjected to the Healthy Eating Index (HEI) questionnaire. The cutoff value for HEI score was determined as 80 points. Patients were evaluated in two groups: group 1 (HEI <80 score) and group 2 (HEI ≥80 score). Complete urine analysis including ketonuria, and thyroid function tests including TSH, T3, and T4 levels were performed for all patients. In addition, the thyroid gland volume of every patient was measured by the same radiologist. RESULTS Increased thyroid gland volume was significantly associated with lower TSH levels (p = .02) and lower HEI scores (p < .001). On the other hand, it was not significantly associated with ketonuria (p = .47), and parity status (p = .82). CONCLUSIONS In our study, we found that there may be an increase in thyroid volume in pregnant women with HEG with lower TSH levels and eating scores. Thyroid volume may predict the patients with probable eating disorders and further studies on thyroid volume in patients with HEG may contribute to the literature.
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Affiliation(s)
- Erhan Okuyan
- Department of Obstetrics and Gynecology, Batman Training and Research Hospital, Batman, Turkey
| | - Ozlem Karabay Akgul
- Department of Obstetrics and Gynecology, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Lena Tureyici
- Department of Obstetrics and Gynecology, Batman Training and Research Hospital, Batman, Turkey
| | - Halit Atac
- Department of Obstetrics and Gynecology, Batman Training and Research Hospital, Batman, Turkey
| | - Mesut Cetin
- Department of Radiology, Batman Training and Research Hospital, Batman, Turkey
| | - Emre Günakan
- Department of Perinatology, Baskent University School of Medicine, Ankara, Turkey
| | - Fethi Karakaya
- Department of Obstetrics and Gynecology, Batman Training and Research Hospital, Batman, Turkey
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Alotaibi EA, AlHaidar AM, Alotaibi SA, Alshehri NA, Alotaibi RA, Bashumeel YY, Nassar R, Batais MA. Assessment of Thyroid Dysfunction Among Pregnant Women With Pre-Existing Diabetes Mellitus or Gestational Diabetes Mellitus. Cureus 2023; 15:e44390. [PMID: 37779813 PMCID: PMC10541241 DOI: 10.7759/cureus.44390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2023] [Indexed: 10/03/2023] Open
Abstract
Objective This study investigates the prevalence and risk of thyroid disturbances in pregnant women with pre-existing diabetes mellitus (DM) or gestational diabetes mellitus (GDM) in a tertiary hospital setting in Riyadh, SA. This research's findings may help identify potential risk factors associated with thyroid disturbances during pregnancy and facilitate early diagnosis for at-risk pregnant women. Subjects and methods A retrospective cross-sectional study was conducted at an endocrinology clinic between October 2018 and December 2021 to evaluate the electronic records of pregnant women with DM or GDM who had documented normal thyroid function before pregnancy. Results Three hundred ninety-six files that met the selection criteria were deeply investigated and analyzed. The analysis showed that 378 (95.5%) patients were of Saudi nationality, and the mean age in years ± SD for the selected patients was 34.23 ± 5.468. The prevalence of obesity was 63.7%, with a mean body mass index (BMI) of 32.78 ± 6.78 kg/m2. The patients in this study were categorized into three groups based on their type of DM: 57 were diagnosed with type 1 DM (14.4%), 120 with type 2 DM (30.3%), and 219 with GDM (55.3%). The study identified 43 patients (10.85%) with subclinical hypothyroidism and 74 (18.69%) with hypothyroidism. Among the remaining patients, thyroid function was within the normal range for 264 (66.67%). The study also identified eight patients (2.02%) with subclinical hyperthyroidism and seven (1.77%) with hyperthyroidism. The prevalence of thyroid dysfunction was reported at 33.4%, with most of the dysfunction observed in the GDM group (20.7%). By comparison, the type 1 DM and type 2 DM groups presented a lower prevalence of thyroid dysfunction, accounting for only 4.1% and 8.6%, respectively. Conclusions Hypothyroidism, both clinical and subclinical, is more prevalent among patients with GDM than individuals with type 1 and type 2 DM. Research suggests a greater risk of developing hypothyroidism in patients with an increased BMI and among those older during pregnancy.
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Affiliation(s)
- Eman A Alotaibi
- Department of Family and Community Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
| | | | - Shahad A Alotaibi
- College of Medicine, Sulaiman Al Rajhi University, Al Bukayriah, SAU
| | - Norah A Alshehri
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, SAU
| | - Raghad A Alotaibi
- College of Medicine, Sulaiman Al Rajhi University, Al Bukayriah, SAU
| | - Yaser Y Bashumeel
- Research, Endocrine and Oncology Division, Department of Surgery, Tulane University School of Medicine, New Orleans, USA
| | - Reema Nassar
- College of Medicine, Omdurman Islamic University, Khartoum, SDN
| | - Mohammed A Batais
- Family Medicine, Diabetes & Chronic Disease Management, King Khalid University Hospital, Riyadh, SAU
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4
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Curí LL, Quesada MDLMR, Despaigne DAN, Savariego EJ, González LC, Konaré DB, Torres ER. References values and predictive factors for thyroid volume in pregnant women. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2023; 67:e000656. [PMID: 37364154 PMCID: PMC10660995 DOI: 10.20945/2359-3997000000656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 03/06/2023] [Indexed: 06/28/2023]
Abstract
Objective Thyroid volume varies within each population according to different clinical and biochemical factors and can change during pregnancy. The present investigation was aimed to determine the reference values for thyroid volume in pregnant women and their predictive factors. Materials and methods A cross-sectional study was carried out with 360 healthy pregnant women. The following variables were examined: maternal age, gestational age, skin color, current smoking status, parity, use of iodinated supplements, body mass index, thyrotropin, total and free thyroid hormones, thyroglobulin, antithyroid antibodies, chorionic gonadotropin, cholesterol and triglycerides. Results The mean thyroid volume was 5.3 ± 1.3 mL, 5.4 ± 1.6 mL and 5.6 ± 2.5 mL in the first trimester, second trimester and third trimester, respectively. The reference interval was 2.47-9.49 mL in the first trimester, 3.17-9.01 mL in the second trimester, and 3.00-12.38 mL in the third trimester. Free triiodothyronine and triglycerides were predictors of thyroid volume (corrected R2 = 0.12; p = 0.000). Conclusion This study is the first to determine the reference values for thyroid volume and its predictive factors in pregnant women from Cuba, a Caribbean island with sustainable elimination of iodine deficiency disorders.
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Affiliation(s)
- Lisette Leal Curí
- Universidad de Ciencias Médicas de La Habana, Cuba,
- Departamento de Docencia e Investigación, Instituto Nacional de Endocrinología, La Habana, Cuba
| | - María de Las Mercedes Rubén Quesada
- Universidad de Ciencias Médicas de La Habana, Cuba
- Departamento de Ciencias de la Computación, Instituto Superior de Ciencias Básicas y Preclínicas "Victoria de Girón", La Habana, Cuba
| | - Daysi Antonia Navarro Despaigne
- Universidad de Ciencias Médicas de La Habana, Cuba
- Departamento de Docencia e Investigación, Instituto Nacional de Endocrinología, La Habana, Cuba
| | - Esther Jequín Savariego
- Universidad de Ciencias Médicas de La Habana, Cuba
- Departamento de Imagenología, Hospital Universitario "Manuel Fajardo", La Habana, Cuba
| | - Lisandro Chávez González
- Universidad de Ciencias Médicas de La Habana, Cuba
- Departamento de Docencia e Investigación, Instituto Nacional de Endocrinología, La Habana, Cuba
| | - Drissa Bina Konaré
- Universidad de Ciencias Médicas de La Habana, Cuba
- Departamento de Docencia e Investigación, Instituto Nacional de Endocrinología, La Habana, Cuba
| | - Erick Robles Torres
- Universidad de Ciencias Médicas de La Habana, Cuba
- Departamento de Docencia e Investigación, Instituto Nacional de Endocrinología, La Habana, Cuba
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Sethy RR, Garg S, Ram D, Tikka SK. Thyroid function in postpartum psychosis: An exploratory study. Asia Pac Psychiatry 2021; 13:e12465. [PMID: 33742554 DOI: 10.1111/appy.12465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 02/10/2021] [Accepted: 03/10/2021] [Indexed: 11/29/2022]
Abstract
The study aimed to compare thyroid function between psychosis with postpartum onset (PPO), psychosis without postpartum onset (PWPO), and normal postpartum females (HC). Twenty women were recruited in each of the three groups. The PPO group had significantly greater psychopathology and shorter episodes compared to the PWPO group. The PPO group was found to have significantly greater right lobe volume than the other groups. The PPO group also had significantly higher FT4 levels than the HC group. We conclude that isolated increase in FT4 and thyroid lobe volumetric changes could be more specifically associated with psychosis of post-partum onset.
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Affiliation(s)
| | - Shobit Garg
- Department of Psychiatry, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, India
| | - Daya Ram
- Department of Psychiatry, Central Institute of Psychiatry, Ranchi, India
| | - Sai Krishna Tikka
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), Raipur, India
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Canovi S, Vezzani S, Polese A, Frasoldati A, Schiatti C, Preda C, Corradini Zini M, Vitiello A, Foracchia M, Comitini G, Aguzzoli L, Fasano T, Vecchia L. Pregnancy-related reference intervals for serum thyrotropin based on real-life clinical data. Gynecol Endocrinol 2021; 37:113-116. [PMID: 32321333 DOI: 10.1080/09513590.2020.1756251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
AIM During pregnancy, thyroid homeostasis is physiologically modified, leading to altered levels of thyrotropin (TSH): hence, the adoption of pregnancy-related, population- and method-specific reference ranges is recommended. This monocentric and retrospective study was conducted to establish local pregnancy-related reference intervals for serum TSH in singleton pregnant women using real-life clinical data. METHODS We included women who measured serum TSH during pregnancy at our Laboratory over six years, excluding pregnant women with current or past history of thyroid disease, pituitary or autoimmune diseases, use of medications known to influence thyroid function, multiple and/or pathological pregnancies, BMI >30 Kg/m2. RESULTS We retrieved a total of 3744 TSH results. Reference limits (90% confidence intervals) for TSH (in mIU/L) are: first trimester 0.09 (0.06-0.12) - 3.16 (3.05-3.29); second trimester 0.25 (0.11-0.30) - 3.55 (3.34-3.73); third trimester 0.42 (0.15-0.48) - 3.93 (3.80-4.08). CONCLUSION In conclusion, real-life clinical data could be used to establish or verify local reference intervals for TSH in pregnant women: this may reduce the risk of misclassification of pregnant women undergoing thyroid function testing.
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Affiliation(s)
- Simone Canovi
- Laboratorio analisi chimico-cliniche e di endocrinologia, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Silvia Vezzani
- Struttura complessa di Endocrinologia, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Alessandra Polese
- Laboratorio analisi chimico-cliniche e di endocrinologia, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Andrea Frasoldati
- Struttura complessa di Endocrinologia, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Clara Schiatti
- Laboratorio analisi chimico-cliniche e di endocrinologia, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Cristina Preda
- Laboratorio analisi chimico-cliniche e di endocrinologia, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Michele Corradini Zini
- Struttura complessa di Endocrinologia, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Antonio Vitiello
- Servizio tecnologie informatiche e telematiche, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Marco Foracchia
- Servizio tecnologie informatiche e telematiche, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Giuseppina Comitini
- Ginecologia e Ostetricia, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Lorenzo Aguzzoli
- Ginecologia e Ostetricia, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Tommaso Fasano
- Laboratorio analisi chimico-cliniche e di endocrinologia, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Luigi Vecchia
- Laboratorio analisi chimico-cliniche e di endocrinologia, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Abstract
Both thyrotoxicosis and hypothyroidism are associated with adverse pregnancy outcomes. There also is concern about the effect of overt maternal thyroid disease on fetal development. In addition, medications that affect the maternal thyroid gland can cross the placenta and affect the fetal thyroid gland. This document reviews the thyroid-related pathophysiologic changes that occur during pregnancy and the effects of overt and subclinical maternal thyroid disease on maternal and fetal outcomes. This Practice Bulletin has been updated with information on the diagnosis and the management of thyroid disease in pregnant women and includes a new clinical algorithm on management of thyroid disease in pregnancy.
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The Clinical Value and Variation of Antithyroid Antibodies during Pregnancy. DISEASE MARKERS 2020; 2020:8871951. [PMID: 33144894 PMCID: PMC7599418 DOI: 10.1155/2020/8871951] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 07/15/2020] [Accepted: 07/31/2020] [Indexed: 01/03/2023]
Abstract
Antithyroid antibodies, which include thyroid-stimulating hormone receptor antibodies (TRAbs), thyroid peroxidase antibodies (TPOAbs), and thyroid globulin antibodies (TgAbs), are widely known for their tight association with thyroid autoimmune diseases. The variation in all three kinds of antibodies also showed different trends during and after pregnancy (Weetman, 2010). This article reviewed the the physiological changes, while focusing on the variation of thyroid antibodies concentration in women during and after pregnancy, and adverse consequences related to their elevation. Since abnormal elevations of these antithyroid antibodies may lead to adverse outcomes in both mothers and fetuses, special attention must be paid to the titer of the antibodies during pregnancy. The molecular mechanisms of the variations in those antibodies have yet to be explained. The frequency and timing of thyroid antibody measurement, as well as different reference levels, also remain to be elucidated.
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Shokri S, Hekmatnia A, Farghadani M, Aminorroaya A, Amini M, Kianpour M, Akbari M, Hekmatnia F. Thyroid volume and nodular and diffuse thyroid diseases by ultrasonography in pregnant women: A case-control study. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2020; 25:13. [PMID: 32174985 PMCID: PMC7053162 DOI: 10.4103/jrms.jrms_42_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 07/17/2018] [Accepted: 10/11/2019] [Indexed: 11/04/2022]
Abstract
Background Currently, it is shown that pregnancy may have an impact on the thyroid that can be leading to pregnancy complications such as abortion, preeclampsia, and preterm delivery. The objective was to compare the thyroid volume, number and characteristics of thyroid nodules, and prevalence of diffuse thyroid diseases in a sample of Iranian pregnant women in the first trimester to nonpregnant women. Materials and Methods This case-control study was conducted on 298 pregnant and 290 nonpregnant women. Thyroid volume, maximum diameter of thyroid nodules and prevalence of moderate to highly suspicious thyroid nodules, Hashimoto's appearance and goiter were assessed using thyroid ultrasonography. Antithyroperoxidase (TPO) antibodies were measured if the sonographic features were highly suggested for Hashimoto's thyroiditis. Results The mean of total thyroid volume in pregnant and nonpregnant women was 6 and 6.5 ml, respectively (P = 0.053), and the median (interquartile range) was 6.2 and 5.5, respectively. Nodules were observed in 16.4% of pregnant and 16.6% of nonpregnant women (P = 0.845). Hashimoto's thyroiditis was detected in 6.7% of pregnant and 12.4% of nonpregnant women (P = 0.013). Anti-TPO antibodies were detected in 5% of pregnant and 9.3% of nonpregnant women (P = 0.034). Conclusion The thyroid volume and nodule characteristics in the first trimester of pregnancy were similar to nonpregnant women. Hashimoto's thyroiditis and anti-TPO antibodies in pregnant women were significantly lower than in nonpregnant women.
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Affiliation(s)
- Saeideh Shokri
- Department of Radiology, School of Medical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Hekmatnia
- Department of Radiology, Signal and Image Processing Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Farghadani
- Department of Radiology, School of Medical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Aminorroaya
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoud Amini
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Kianpour
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mojtaba Akbari
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farzaneh Hekmatnia
- Department of Medicine, Southend University Hospital, Southend-on Sea, United Kingdom, Southend University Hospital, Westcliff-on-Sea, England, UK
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Fallatah AM, Hasanain A, Babatin H, Nassibi KM, Thigah S, Abduljabbar HS. Pregnancy Outcomes among Obese Pregnant Women with Hypothyroidism: Medical Record Review of a Single Tertiary Center in Saudi Arabia. Cureus 2020; 12:e6938. [PMID: 32190490 PMCID: PMC7067361 DOI: 10.7759/cureus.6938] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background Thyroid disorder is common among pregnant women. Hashimoto thyroiditis is the most common etiology of hypothyroidism among pregnant women. Many studies showed that hypothyroidism during pregnancy has been associated with negative outcomes for the mother and for child as well including miscarriage, intrauterine growth retardation, preterm delivery and cognitive impairment in the offspring. Objectives To assess the adverse maternal and neonatal outcome among hypothyroidism obese pregnant women. Methods This is a retrospective study conducted among obese pregnant women diagnosed with hypothyroidism attending King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia between January 1, 2013, and December 31, 2018. For analysis, we used (1) descriptive statistics, (2) Chi-square test, Pearson correlation, independent t-test, and one-way ANOVA to test the difference in thyroid stimulating hormone (TSH) levels and adverse pregnancy outcomes. A p-value of <0.05 is used to calculate statistical significance. Results A total of 9095 pregnant women had delivered in the last five years, 65 of these pregnant women had been diagnosed with hypothyroidism and 57 were enrolled in our study. Out of 65, 44 (77.2%) were Saudi, and 13 (22.8%) non-Saudis. Mean age at the time of delivery was 32.9 ± 5.6 years, while BMI means were 35.7 ± 4.6. A total of 35 (61.4%) were from class 1, 14 (26.2%) were from class 2 and eight (12.3%) were from class 3. Out of 57, 16 (28.1%) developed undesired antepartum outcomes, while 14 (21.5%) had postpartum outcomes. Preterm labor, gestational diabetes mellitus, and urinary tract infections were significantly associated with abnormal TSH levels (P < 0.05). Conclusion As demonstrated earlier, hypothyroidism during pregnancy leads to unfavorable outcomes. Therefore, screening for thyroid function tests in prenatal and antenatal periods is vital to avoid potential adverse outcomes.
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Elebrashy I, Kamal Eldein HA, Abd-Elstar H, Ghanem N, Mousa S, Assem M, Rashed L, Salit M, Abd-Elraoof M, Dorgham A, Mansour A, Mahmoud M, Saif A. Assessment of thyroid functions and thyroid volume in normal pregnant Egyptian females. Gynecol Endocrinol 2020; 36:122-125. [PMID: 31230489 DOI: 10.1080/09513590.2019.1631279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
The normal range of thyroid functions during pregnancy differs between ethnic groups. This study assessed the thyroid functions in normal pregnant Egyptian females. Thyroid peroxidase antibodies (TPO Abs) and thyroid volume were also assessed. The study included 150 normal pregnant Egyptian females, recruited from Cairo University Hospital Antenatal Care Clinic (50 in each trimester), with 40 age-matched non-pregnant females, as a control group. Serum thyroid stimulating hormone (TSH) and TPO Abs were measured. Thyroid volume was assessed by ultrasonography. TSH ranges were 0.21-1.7, 0.52-3.2 and 0.72-2.6 mIU/L during first, second and third trimesters, respectively. The mean TSH level in pregnant females was significantly lower than that of non-pregnant women (1.2 ± 0.7 vs 2.7 ± 0.9 mIU/L, p < .001). TPO Abs were significantly higher in the first trimester compared to both second and third trimesters (p < .001 for both). Thyroid volume of pregnant females was non-significantly higher than that of non-pregnant control subjects (p = .126). A significant positive correlation was found between thyroid volume and body mass index in pregnant females (p < 0.001). Our study established trimester-specific reference ranges for thyroid functions in normal pregnant Egyptian females. A larger population-based study would help to confirm those ranges. Thyroid volume was non-significantly higher than that of non-pregnant control subjects.
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Affiliation(s)
| | | | - Hoda Abd-Elstar
- Departments of Internal Medicine, Cairo University, Cairo, Egypt
| | - Nashwa Ghanem
- Departments of Internal Medicine, Cairo University, Cairo, Egypt
| | - Shrook Mousa
- Departments of Internal Medicine, Cairo University, Cairo, Egypt
| | - Maha Assem
- Departments of Internal Medicine, Cairo University, Cairo, Egypt
| | - Laila Rashed
- Department of Medical Biochemistry, Cairo University, Cairo, Egypt
| | - Mohamed Salit
- Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt
| | - Maged Abd-Elraoof
- Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt
| | - Ahmed Dorgham
- Departments of Internal Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Mansour
- Departments of Internal Medicine, Cairo University, Cairo, Egypt
| | - Mohamed Mahmoud
- Departments of Internal Medicine, Cairo University, Cairo, Egypt
| | - Aasem Saif
- Departments of Internal Medicine, Cairo University, Cairo, Egypt
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12
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Jia M, Wu Y, Lin B, Shi Y, Zhang Q, Lin Y, Wang S, Zhang Y. Meta-analysis of the association between maternal subclinical hypothyroidism and gestational diabetes mellitus. Int J Gynaecol Obstet 2019; 144:239-247. [PMID: 30578669 DOI: 10.1002/ijgo.12751] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 08/02/2018] [Accepted: 12/20/2018] [Indexed: 11/09/2022]
Abstract
BACKGROUND Subclinical hypothyroidism (SCH) and gestational diabetes mellitus (GDM) are common endocrine disorders that occur during pregnancy. OBJECTIVE To determine whether the risk of GDM differs between pregnant women with normal thyroid function and those with SCH. SEARCH STRATEGY MEDLINE, EMBASE, the Cochrane Library, and Web of Science were searched for studies published in English from inception to March 1, 2017, using combinations of the search terms "thyroid dysfunction", "thyroid diseases", "subclinical hypothyroidism", "hypothyroxinemia", "thyrotropin", "gestational diabetes", "hyperglycemia in pregnancy", and "adverse pregnancy outcomes". SELECTION CRITERIA We selected cohort studies that included pregnant women with SCH; in which the outcome of interest was, or included, the incidence of GDM; and that had data available for both the SCH and GDM groups. Studies were excluded if assisted reproductive technologies were used to achieve pregnancy; reviews, abstracts, and case reports were also excluded. DATA COLLECTION AND ANALYSIS Eleven studies were included in the analysis. Summary odds ratios (ORs) for the risk of GDM were calculated. MAIN RESULTS SCH with positive antithyroid autoantibodies markedly increased GDM risk (OR 3.22, 95% confidence interval 1.72-6.03, I2 =55%). CONCLUSION SCH with positive antithyroid autoantibodies in pregnancy is associated with an increased risk of GDM.
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Affiliation(s)
- Minghan Jia
- Department of Thyroid and Breast Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Breast Cancer, Cancer Center, Guangdong General Hospital & Guangdong Academy of Medical Science, Guangzhou, China
| | - Yanxin Wu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Bo Lin
- Department of Thyroid and Breast Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yawei Shi
- Department of Thyroid and Breast Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qi Zhang
- Department of Thyroid and Breast Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ying Lin
- Department of Thyroid and Breast Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Shenming Wang
- Department of Vascular Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yunjian Zhang
- Department of Thyroid and Breast Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Torres MT, Francés L, Vila L, Manresa JM, Falguera G, Prieto G, Casamitjana R, Toran P. Iodine nutritional status of women in their first trimester of pregnancy in Catalonia. BMC Pregnancy Childbirth 2017; 17:249. [PMID: 28747228 PMCID: PMC5530553 DOI: 10.1186/s12884-017-1423-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 07/18/2017] [Indexed: 01/28/2023] Open
Abstract
Background Sufficient iodine intake is needed during pregnancy to ensure proper fetal development. The iodine levels of women in their first trimester of pregnancy in Catalonia are currently unknown. This data would help to determine whether our public health services should establish recommendations or interventions in this line. The aim of this study was to investigate the iodine nutritional status, prevalence of urinary iodine <150 μg/L, and tobacco use in the first trimester of pregnancy in our setting. Methods Cross-sectional study. Data were collected during 2008–2009 from women in their first trimester at the primary care centers of the province of Barcelona (Spain). Pregnant women included in the study completed a questionnaire on eating habits and underwent urinary iodine concentration (UIC) assessment. Results Nine hundred forty five women completed the dietary questionnaire and urinary iodine testing. Median UIC was 172 μg/L, with 407 participants (43.1%) showing levels <150 μg/L. On multivariate logistic regression analysis, intake of 1–2 glasses of milk per day, OR = 0.636 95% CI (0.45–0.90) or >2 glasses, OR = 0.593 95% CI (0.37–0.95); iodized salt consumption, OR = 0.678 95% CI (0.51–0. 90); and use of iodine supplementation, OR = 0.410 95% CI (0.31–0.54), protected against the risk of UIC <150 μg/L. Simultaneous consumption of iodized salt and milk (≥1 glass/day) showed a larger protective effect: OR = 0.427, 95% CI (0.31–0.54). Conclusion The median UIC of the pregnant women surveyed indicated an acceptable iodine nutritional status according to the criteria established by the WHO and ICCIDD. The risk of urinary iodine <150 μg/L decreased with simultaneous consumption of milk and iodized salt, similar to the decrease seen with iodine supplementation. Electronic supplementary material The online version of this article (doi:10.1186/s12884-017-1423-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maria Teresa Torres
- Atenció a la Salut Sexual i Reproductiva (ASSIR), CAP Antoni Creus i Querol, Institut Català de la Salut, Terrassa, Barcelona, Spain. .,Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Sabadell, Barcelona, Spain. .,GRASSIR research group, IDIAP Jordi Gol, Generalitat de Catalunya, Barcelona, Spain. .,Departament d'Infermeria, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain.
| | - Lidia Francés
- Departament d'Infermeria, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Lluis Vila
- Servicio de Endocrinología y Nutrición, Hospital de Sant Joan Despí 'Moisès Broggi', Sant Joan Despí, Barcelona, Spain
| | - Josep María Manresa
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Sabadell, Barcelona, Spain.,GRASSIR research group, IDIAP Jordi Gol, Generalitat de Catalunya, Barcelona, Spain.,Departament d'Infermeria, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - Gemma Falguera
- GRASSIR research group, IDIAP Jordi Gol, Generalitat de Catalunya, Barcelona, Spain.,Atenció a la Salut Sexual i Reproductiva (ASSIR) Gerència Territorial Metropolitana Nord, Institut Català de la Salut, Sabadell, Barcelona, Spain
| | | | - Roser Casamitjana
- Centro de Diagnóstico Biomédico - Bioquímica y Genética Molecular, Hospital Clínic, Barcelona, Spain
| | - Pere Toran
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Sabadell, Barcelona, Spain
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14
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Vannucchi G, Covelli D, Vigo B, Perrino M, Mondina L, Fugazzola L. Thyroid volume and serum calcitonin changes during pregnancy. J Endocrinol Invest 2017; 40:727-732. [PMID: 28229359 DOI: 10.1007/s40618-017-0622-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 01/19/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND Pregnancy has a profound impact on thyroid homeostasis which results in change of thyroid function and thyroid volume (TV). Moreover, calcitonin (CT), and its gene-related peptide have been demonstrated to play an important role in the implantation process. PURPOSE To evaluate changes in TV and serum CT levels during pregnancy. METHODS One hundred and fifty-five pregnant women were consecutively enrolled at the first trimester of gestation and underwent clinical, biochemical and sonographic assessment at enrollment, at the second and third trimesters and at 6 months after delivery. RESULTS Throughout gestation serum TSH exceeded the upper specific first trimester cut-off in 5% of patients. TV significantly increased at the third trimester of gestation and returned to baseline levels at 6 months after delivery, while serum CT levels did not show significant changes. TV directly correlated with BMI or gestational weight gain at each trimester of pregnancy, while no significant association between serum CT levels and either weight or TV were found. Finally, in none of the patients with nodular goiter an increase in the volume of the nodules was noted. The appearance of a nodule was recorded during the second trimester in one patient. CONCLUSION This study confirms a prevalence of thyroid autoimmunity/hypertropinemia in 3-5% of pregnant women and shows that serum CT does not change in relation to the transient increase in TV occurring during gestation. An adequate daily iodine supplementation might be particularly useful during pregnancy to limit the TSH increase and the resulting thyroid gland and nodule enlargement.
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Affiliation(s)
- G Vannucchi
- Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy.
- Endocrine Unit, Padiglione Granelli, Fondazione IRCCS Ca' Granda, Via F. Sforza, 35, 20122, Milan, Italy.
| | - D Covelli
- Endocrine Unit, Padiglione Granelli, Fondazione IRCCS Ca' Granda, Via F. Sforza, 35, 20122, Milan, Italy
| | - B Vigo
- Endocrine Unit, Padiglione Granelli, Fondazione IRCCS Ca' Granda, Via F. Sforza, 35, 20122, Milan, Italy
| | - M Perrino
- Endocrine Unit, Padiglione Granelli, Fondazione IRCCS Ca' Granda, Via F. Sforza, 35, 20122, Milan, Italy
| | - L Mondina
- Family Counselling Center, Milan, Italy
| | - L Fugazzola
- Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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15
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Ezzeddine D, Ezzeddine D, Hamadi C, Abbas HA, Nassar A, Abiad M, Ghazeeri G. Prevalence and Correlation of Hypothyroidism With Pregnancy Outcomes Among Lebanese Women. J Endocr Soc 2017; 1:415-422. [PMID: 29264496 PMCID: PMC5686637 DOI: 10.1210/js.2017-00014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 03/17/2017] [Indexed: 11/19/2022] Open
Abstract
Purpose: Assessment of hypothyroidism prevalence and clinical significance among pregnant women in Lebanon. Methods: We performed a single-center retrospective cohort study at the American University of Beirut Medical Center. Clinical, demographic, and laboratory data were collected and analyzed using trimester-specific ranges for hypothyroidism. Results: Of 920 pregnant women, 17% had hypothyroidism during gestation. A history of previous miscarriage and morbid obesity were associated with hypothyroidism during pregnancy. Pregnant women with hypothyroidism were more likely to experience a miscarriage during the first trimester [odds ratio, 2.9; 95% confidence interval, (1.13 to 7.5); P = 0.02] and delivery at post-term (odds ratio, 3.9; 95% confidence interval, 1.05 to 14.9; P = 0.05). We found no substantial correlation with preterm or premature delivery, cesarean section delivery, or gestational hypertension despite increased odds among the hypothyroidism group. No substantial differences were found with respect to the fetal outcomes between the control and hypothyroidism groups. Conclusions: Hypothyroidism is prevalent in 17% of pregnant women in Lebanon and was associated with a history of miscarriage and morbid obesity. The presence of hypothyroidism correlated with miscarriage during the first trimester and with post-term delivery. Despite the lack of sufficient data supporting the efficacy of treatment of hypothyroidism during gestation, more studies should be conducted to assess the effect of hypothyroidism on gestational and fetal outcomes.
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Affiliation(s)
- Dima Ezzeddine
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon
| | - Diala Ezzeddine
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon
| | - Caroline Hamadi
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon
| | - Hussein A Abbas
- School of Medicine, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon
| | - Anwar Nassar
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon
| | - May Abiad
- Department of Biology, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon
| | - Ghina Ghazeeri
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon
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Gaberšček S, Osolnik J, Zaletel K, Pirnat E, Hojker S. An Advantageous Role of Spectral Doppler Sonography in the Evaluation of Thyroid Dysfunction During the Postpartum Period. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2016; 35:1429-1436. [PMID: 27208199 DOI: 10.7863/ultra.15.07033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 10/16/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVES To evaluate the diagnostic value of spectral Doppler sonography in women with thyroid dysfunction during the first postpartum year. METHODS This prospective observational clinical study included 83 consecutive untreated women: 32 with hyperthyroid postpartum thyroiditis, 32 with hypothyroid postpartum thyroiditis, and 19 with Graves disease, which first appeared within 12 months after delivery. Thyrotropin, free thyroid hormones, thyroid peroxidase antibodies, thyroglobulin antibodies, and thyrotropin receptor antibodies were measured. With a 7.5-MHz linear transducer, we measured the thyroid volume and peak systolic velocity (PSV) at the level of intrathyroid arteries. RESULTS Hyperthyroid postpartum thyroiditis appeared significantly earlier (mean ± SD, 4.4 ± 1.9 months after delivery) than hypothyroid postpartum thyroiditis (6.5 ± 2.1 months) and Graves disease (7.2 ± 2.7 months; P< .001). The thyroid volume in hyperthyroid postpartum thyroiditis (9.7 ± 6.3 mL) was significantly lower than in hypothyroid postpartum thyroiditis (14.7 ± 10.2 mL; P = .030) and Graves disease (19.4 ± 10.2 mL; P< .001). The PSV in hyperthyroid postpartum thyroiditis (9.4 ± 3.4 cm/s) was significantly lower than in hypothyroid postpartum thyroiditis (14.4 ± 3.9 cm/s; P < .001) and Graves disease (19.8 ± 7.0 cm/s; P < .001). With a cutoff level of 15 cm/s, the sensitivity and specificity of the PSV as a predictor of the correct diagnosis in hyperthyroid postpartum women were 94.7% and 96.8%, respectively. A multinomial logistic regression revealed PSV and the time after delivery at which the disorders presented as independent predictors of the differentiation between hyperthyroid postpartum thyroiditis and Graves disease (P = .003; P = .022). CONCLUSIONS Spectral Doppler sonography was shown to be a useful and accurate method for thyroid dysfunction evaluation during the postpartum period.
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Affiliation(s)
- Simona Gaberšček
- Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia. Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Jasna Osolnik
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Katja Zaletel
- Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Edvard Pirnat
- Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Sergej Hojker
- Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia. Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Sahin SB, Ogullar S, Ural UM, Ilkkilic K, Metin Y, Ayaz T. Alterations of thyroid volume and nodular size during and after pregnancy in a severe iodine-deficient area. Clin Endocrinol (Oxf) 2014; 81:762-8. [PMID: 24811142 DOI: 10.1111/cen.12490] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Revised: 03/31/2014] [Accepted: 05/01/2014] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The effects of pregnancy on thyroid nodules were investigated in a few number of studies. We aimed to evaluate the prevalence of thyroid nodules, the changes in size, volume and number of nodules during pregnancy and after delivery in pregnant women. DESIGN AND METHODS This prospective study was performed in a severe iodine-deficient area and included 83 pregnant women (mean age 30·4 ± 5·5 years). We evaluated thyroid hormone levels, ultrasound examination of thyroid and urine iodine concentration (UIE) at each trimester and at 3-month post-partum period (PP). All patients with thyroid nodules >1 cm underwent fine-needle aspiration biopsy (FNAB) after the last visit at the PP. RESULTS Twenty-six women had thyroid nodules on thyroid ultrasonography at the first trimester. The volume of single/dominant nodule showed enlargement during pregnancy and remained at the PP; however, it was not significant (first trimester: 0·83 ± 0·8 ml; second trimester: 0·92 ± 1 ml; third trimester: 0·99 ± 1·2 ml; PP: 0·92 ± 1·2 ml). The maximum diameter of single/dominant nodule in the third trimester of pregnancy (12·6 ± 5·4 mm) was greater than the first trimester (11·9 ± 4·8 mm) (P = 0·002). The number of nodules did not change during pregnancy. The mean TV increased during pregnancy and remained 3 months after delivery (P < 0·001), and the maximum value of TV was reached in the third trimester (14·2 ± 7·9 ml). FNAB results revealed a 6·6% prevalence of malignancy among the nodules. CONCLUSIONS Thyroid nodules were present in 30·1% of pregnant women. While size of the single/dominant thyroid nodule increased significantly during pregnancy, the number of nodules did not change.
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Affiliation(s)
- Serap B Sahin
- Department of Endocrinology and Metabolism Disease, Recep Tayyip Erdogan University Medical School, Rize, Turkey
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19
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Gaberšček S, Zaletel K. Thyroid physiology and autoimmunity in pregnancy and after delivery. Expert Rev Clin Immunol 2014; 7:697-706; quiz 707. [DOI: 10.1586/eci.11.42] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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20
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Thyroid Doppler indices in patients with sickle cell disease. Clin Imaging 2013; 37:852-5. [PMID: 23834903 DOI: 10.1016/j.clinimag.2013.05.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 05/20/2013] [Accepted: 05/30/2013] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate the intrathyroidal hemodynamic changes and thyroidal volume in sickle cell disease (SCD) patients. METHODS Thirty-two patients with homozygous SCD and 32 control subjects were examined with color Doppler ultrasonography. None of the patients and control subjects had clinical or laboratory evidence of thyroid disease. RESULTS SCD patients had significantly higher resistance index (RI) and pulsatility index (PI) values and lower thyroid volume compared with control group. CONCLUSION Increased intrathyroidal RI and PI and decreased thyroid volume may be due to impaired thyroidal microcirculation. Further and follow-up studies are needed to explain the relationship between Doppler parameters and thyroid functions.
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Abduljalil K, Furness P, Johnson TN, Rostami-Hodjegan A, Soltani H. Anatomical, Physiological and Metabolic Changes with Gestational Age during Normal Pregnancy. Clin Pharmacokinet 2012; 51:365-96. [DOI: 10.2165/11597440-000000000-00000] [Citation(s) in RCA: 220] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Wang QW, Yu B, Huang RP, Cao F, Zhu ZQ, Sun DC, Zhou H. Assessment of thyroid function during pregnancy: the advantage of self-sequential longitudinal reference intervals. Arch Med Sci 2011; 7:679-84. [PMID: 22291805 PMCID: PMC3258790 DOI: 10.5114/aoms.2011.24139] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2010] [Revised: 05/15/2011] [Accepted: 06/19/2011] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION To evaluate clinical value of a new self-sequential longitudinal reference intervals of thyroid function during pregnancy. MATERIAL AND METHODS WE ESTABLISHED TWO DIFFERENT SERIES OF REFERENCE INTERVALS: self-sequential longitudinal reference intervals (SLRI) and general gestation-specific reference intervals (GSRI). For SLRI, the serum of 301 cases were collected five times in every case throughout the gestation. For GSRI, A total of 1455 subjects included in the study. We collected the serum respectively at various trimesters. We used TSH of both reference intervals to screen 1744 pregnant women, and compared the percentage of potential misclassification. RESULTS Both SLRI and GSRI differed substantially from that for non-pregnant women (p < 0.05). There are similar fluctuations of serum TSH, FT4 and TPO-Ab during normal pregnancy. Although there were no significant differences in most reference intervals between SLRI and GSRI. But the IQR of SLRI were usually smaller than GSRI , especially in 1(st) trimester. Two hundred and fifty two women (14.4%) at various trimesters whose serum TSH concentration was within SLRI would be misclassified, while 23 women (1.3%) with a TSH concentration outside limit would not be identified. 0.11-3.84% women would got thyroid diseases during pregnancy. Subclinical hypothyroidism is most common maternal thyroid disorders. CONCLUSIONS The SLRI can reflected the changes of thyroid function realistically, and can be used to decrease the percentage of potential misclassification of thyroid dysfunction during pregnancy. Screening for thyroid dysfunction of pregnant women is recommended and important.
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Affiliation(s)
- Qiu-Wei Wang
- Changzhou Women and Children Health Hospital to Nanjing Medical University, Jiangsu Province, China
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Jiskra J, Bartáková J, Holinka Š, Límanová Z, Springer D, Fait T, Antošová M, Telička Z, Potluková E. Low concordance between positive antibodies to thyroperoxidase and thyroid ultrasound autoimmune pattern in pregnant women. Endocr J 2011; 58:849-59. [PMID: 21873803 DOI: 10.1507/endocrj.ej11-0026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The diagnostic and prognostic role of thyroid ultrasound (TUS) in pregnant women positive for antibodies to thyroperoxidase (TPOAb) is unclear. The aim of our study was to compare the relation of ultrasound thyroid texture to the thyroid laboratory tests in pregnant women and controls. Using a semi-quantitative assessment we compared TUS in two groups of women with positive TPOAb and/or with thyroid dysfunction (TSH out of 0.06-3.67 mIU/L): 186 women in 1(st) trimester of pregnancy recruited from universal screening and 67 asymptomatic age-comparable non-pregnant non-postpartum women recruited from screening of general population (controls). Women with previous history of thyroid diseases were excluded. Only 64/131 (48.9 %) of TPOAb-positive pregnant women were TUS-positive (TUS with autoimmune pattern) in comparison with 35/49 (71.4 %) TPOAb-positive controls (p <0.011). Pregnant women had more often TSH >10.0 mIU/L if they were TPOAb-positive/TUS-positive as compared to those TPOAb-positive/TUS-negative (8/64 (12.5 %) vs. 0/67 (0 %), p = 0.009). The prevalence of preterm deliveries among TPOAb-positive women was significantly lower if TPOAb-positivity was not accompanied by TUS-positivity (2/67 (3.0 %) vs. 10/64 (15.6 %) in TPOAb-positive/TUS-positive women, p = 0.028). In conclusion, nearly half of the TPOAb-positive pregnant women did not have an autoimmune pattern in TUS. Normal TUS image in TPOAb-positive pregnant women might be a protective factor for preterm delivery.
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Affiliation(s)
- Jan Jiskra
- 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic.
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Fister P, Gaberscek S, Zaletel K, Krhin B, Hojker S, Gersak K. Thyroid function in the third trimester of pregnancy and after delivery in an area of adequate iodine intake. Int J Gynaecol Obstet 2010; 112:52-5. [DOI: 10.1016/j.ijgo.2010.07.029] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2010] [Revised: 07/17/2010] [Accepted: 09/14/2010] [Indexed: 11/16/2022]
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