Thyroid disease in preg

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Post-Partum Thyroiditis

Hypothyroidism

Universal screening currently not practiced, but a low threshold to test seems reasonable.

Newly found:
[ ] Overt - Treat w/ Levothyroxine 1.6 mcg/kg/day
[ ] Subclinical - consider Levothyroxine 1 mcg/kg/day
[ ] Recheck TSH & fT4 q 4 wk til stable, qtrimester when stable
Reasonable goal of TSH <2.5-3.0 (Lower than non-pregnant)& fT4 in normal range
[ ] Post-partum may need to decrease by 1/3 and recheck TSH.
Previously Diagnosed
[ ] Take 9 doses/wk when pregnancy discovered. ((Dose may increase by as much as 50%)
[ ] Recheck TSH & fT4 q 4 wk til stable, qtrimester when stable
Reasonable goal of TSH <2.5-3.0 (Lower than non-pregnant)& fT4 in normal range
[ ] Post-partum may return to pre-pregnancy dose, recheck TSH in 2-3 mos.
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