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MS WordPerinatologist Corner - C.E.U/C.M.E. Modules
Thyroid Disorders in Pregnancy
Sponsored by The Indian Health Service Clinical Support Center
10. I.H.S. on-line resources
For additional resources please go to 11 Other Online Resources.
UpToDate software
[Notes: Click on the links below, and then the Accept button on the screen that comes up.]
Overview of thyroid disease in pregnancy
Ross, Douglas UpToDate software 12.1, 2004
Hyperemesis gravidarum
Bacq, Yannick, Riely, Caroline UpToDate software 12.1, 2004
Chorionic gonadotropin, hyperemesis gravidarum, trophoblastic disease, and hyperthyroidism
Ross, Douglas UpToDate software 12.1, 2004
Characteristics of antiemetic drugs
Longstreth, George, Hesketh, Paul
UpToDate software 12.1, 2004
Postpartum thyroiditis
Burman, Kenneth UpToDate software 12.1, 2004
Approach to the patient with weight loss
Rolla, Arturo UpToDate software 12.1, 2004
Approach to liver disease occurring during pregnancy
Yannick B, Reily C. UpToDate software 12.1, 2004
Clinical manifestations and diagnosis of gestational trophoblastic disease.
Ainbinder S, Berek J. UpToDate software 12.1, 2004
Triplet pregnancy: Incidence and early pregnancy management
Jones, David UpToDate software 12.1, 2004
Cochrane Library
Mahomed K , Gülmezoglu AM. Maternal iodine supplements in areas of deficiency (Cochrane Review). In: The Cochrane Library, Issue 1, 2004. Oxford: Update Software.
Implications for practice
Iodine supplementation should be provided in areas with low iodine intake. The form of supplementation should take into consideration, the severity of iodine deficiency, costs and availability of different preparations. Nationwide iodisation programmes should be implemented in countries where iodine deficiency disorders are seen in order to eliminate this problem. There is a suggestion of harmful effects in adults in observational studies and monitoring of iodine supplementation programmes is therefore necessary.
Wu T, Liu GJ, Li P, Clar C. Iodised salt for preventing iodine deficiency disorders (Cochrane Review). In: The Cochrane Library, Issue 1, 2004. Oxford: Update Software.
Implications for practice
The results suggest that iodised salt is an effective means of improving iodine status and support the current endeavours to achieve universal salt iodisation. Variations in the iodine levels in the salt used by some studies suggest that particular care must be taken to ensure the quality of the production and storage of iodised salt - and that there may be situations in which other forms of iodine supplementation may be more appropriate. There was also a suggestion that forms of iodine supplementation should be reassessed in small children, as their salt intake may not be high enough to guarantee adequate iodine levels through the use of iodised salt. There was no suggestion from the studies that the use of iodised salt with the levels of iodine studied had any unwanted side effects, although this point must be regarded with caution as most studies did not specifically consider adverse effects.
Crowther CA, Alfirevic Z, Haslam RR. Prenatal thyrotropin-releasing hormone for preterm birth (Cochrane Review). In: The Cochrane Library, Issue 1, 2004. Oxford: Update Software.
Implications for practice
On the basis of currently available evidence, prenatal TRH, in addition to corticosteroids, given to women at risk of very preterm birth cannot be recommended for clinical practice.
Osborn DA. Thyroid hormones for preventing neurodevelopmental impairment in preterm infants (Cochrane Review). In: The Cochrane Library, Issue 1, 2004. Oxford: Update Software.
Implications for practice
This review does not support the use of thyroid hormones in preterm infants to reduce neonatal mortality, improve neurodevelopmental outcome or reduce the severity of respiratory distress syndrome. The post hoc analyses of data from one study (van Wassenaer 1997) which showed benefits in infants 24-25 weeks' gestation should be treated with caution. There is no evidence of benefit from treatment of transient hypothyroxinemia in preterm infants.
* Notes: The resources above are available only if you have reached this page from the I.H.S. wide-area network (W.A.N.)
