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Thyroid Disease in Preconception, Pregnancy, and Postpartum

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Physiology, Laboratory Testing, and Iodine 4 TSH TPOAb and TgAb No (thyroidal) effects on fetus or newborn TSHR-Ab Depending on subtype, can stimulate or block the fetal thyroid Iodine a Necessary for fetal thyroid hormone production Radioactive iodine Destruction of fetal thyroid gland Propylthiouracil and methimazole Inhibit fetal thyroid function Propranolol Considered safe, associated with slightly lower birth weight (Lio)triiodothyronine (Levo)thyroxine Regulates fetal growth and development Mother Placenta Figure 2. Transplacental Passage of Thyroid Parameters and Drugs a Iodine overload may also result in fetal/neonatal hypothyroidism. Maternal TSHR-Ab, iodine, radioactive iodine, the antithyroid drugs (propylthiouracil and methimazole), propanolol, and the thyroid hormones [(lio)thyronine and (levo)thyroxine] all traverse the placenta and have the potential to induce direct effects to the fetus. No placental passage Placental passage but no effects on fetus

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