It is an established fact that thyroid hormones play an important role in the metabolism of the body. Pregnancy is a state of significant hormonal as well as metabolic changes, and thyroid hormones have a significant impact on maternal metabolism and fetal development during pregnancy. The fetus relies on maternal thyroid hormone for the development of the CNS, especially in the early stages of gestation, and uncorrected maternal hypothyroidism in this period can leave the child with permanent life-long neurological deficits. From the maternal point of view, a thyroid dysfunction encountered during pregnancy may continue even after delivery as postpartum thyroiditis. Hence, any thyroid dysfunction, be it hypo- or hyperthyroidism, can have serious deleterious consequences if not detected promptly and managed properly. The established guidelines and newer trends for the treatment of thyroid dysfunction are discussed in this update. Thyroid hypofunction has also been known to affect the fertility of women in reproductive age group. With the increasing incidence of infertility and advent of methods to treat them, the early detection and adequate treatment of thyroid hypofunction becomes an unavoidable part of assisted reproductive techniques, in the present day scenario. Even subclinical thyroid disorders can affect the reproductive capacity of non-pregnant women and impact the fetomaternal wellbeing in those who conceive. However, not all cases of subclinical hypothyroidism warrant pharmacological treatment. The guidelines for treatment of subclinical hypothyroidism in the pregnant and non-pregnant states are discussed in detail in this clinical update. An important aspect of reproductive health is family planning, and one of the commonly used means to achieve it is hormonal contraceptives. The interaction of thyroid hormones with hormonal contraceptives and the means of testing thyroid dysfunction in an individual taking hormonal contraceptives have been elucidated in this update.

This book is a practical, evidence-based resource covering thyroid disease and its effects on reproduction and fertility, discussing thyroid function and dysfunction - hypothyroidism and hyperthyroidism, thyroid nodules and cancer - during pregnancy as well as its effects on the fetus. It begins with a review of the anatomy and function of the thyroid and the biosynthesis and physiology of thyroid hormones, as well as the pathophysiology of thyroid dysfunction. The chapters that follow discuss thyroid function and dysfunction (e.g., hypothyroidism and hyperthyroidism) during pregnancy and its effects on fertility as well as the developing fetus. The management of thyroid nodules and cancer, the role of thyroid dysfunction in infertility, the role of thyroid autoimmunity and miscarriage, and postpartum thyroiditis are presented in detail in the concluding chapters. Clinical cases and outcomes bookend each chapter, demonstrating current management strategies for a well-rounded presentation. Filling a clear gap in the literature usually covered only briefly in larger texts on the thyroid, Thyroid Disease and Reproduction: A Clinical Guide to Diagnosis and Management is a unique resource for reproductive endocrinologists, obstetrician/gynecologists, and residents and students in these clinical areas.

This book provides a comprehensive overview of various thyroid disorders in pregnancy. Merging clinical evidence with their own professional experience, international experts in the field report on novel research and share insights on a broad range of topics, from addressing the normal physiology of the thyroid in pregnancy, to the safe treatment of disorders during pregnancy. Given its scope, the book is chiefly intended for internists, obstetricians, gynecologists, endocrinologists and related sub-specialists; however, it will also benefit general physicians.

This book focuses on all aspects of thyroid disease in women during pregnancy, preconception and the postpartum period. Exceptional emphasis is provided on screening for thyroid dysfunction before and during pregnancy and interpretation of thyroid function tests in pregnancy. The chapters cover the topics on the role of Iodine, thyroid autoantibodies, hypothyroidism , thyrotoxicosis and thyroid nodules / cancer in pregnant women and postpartum thyroiditis with helpful illustrations and clear flow charts. This book serves as a resourceful guide for clinicians and medical practitioners in managing thyroid disease and related complications in women at different stages of pregnancy.

The management of medical disorders in pregnancy has undergone significant changes in the recent years. The pattern of disease has changed with improvements in socio-economic conditions. For example, the incidence of antenatal anemia has decreased progressively in the past few decades, and pulmonary tuberculosis (which used to be prevalent) is now seen only rarely. Chronic rheumatic heart disease has also become less common. On the other hand, gestational diabetes has become more common. This may be due partly to the setting up of screening services for gestational diabetes in many hospitals. The four most common medical disorders complicating pregnancy are anemia, diabetes mellitus, cardiac disease, and thyroid disorders. In addition, because of the improvements in the medical, obstetric, and anesthetic management of pregnancy, many women with medical disorders can go through a pregnancy without major problems. There has also been a progressive decrease in the perinatal mortality associated with some medical disorders, such as diabetes. It is important for all healthcare professionals involved in the management of pregnant women with medical disorders to be conversant with the latest developments in order to provide the best care to these women. The chapters in this issue are certainly helpful in this respect. The eminent authors for the various chapters have discussed the various options available describing in detail their experiences regarding the various aspects of the condition.

Recurrent miscarriage is a distressing problem that affects 1% of all women in the reproductive age group. This incidence is greater than that expected by chance alone, since 10–15% of all clinically recognised pregnancies end in a miscarriage. The calculated risk of three consecutive pregnancy losses is estimated to be 0.34%. Hence, only a proportion of women presenting with recurrent miscarriage will have a persistent underlying cause for their pregnancy losses. Maternal age and previous number of miscarriages are two independent risk factors for a further miscarriage. The advanced maternal age adversely affects ovarian function, giving rise to a decline in the number of good quality oocytes, resulting in chromosomally abnormal conceptions that rarely develop further. The eminent authors for "Recurrent Pregnancy Loss" have enumerated the various options available described in detail their experiences regarding the various aspects of the condition.

Nutrition and Pregnancy - ECAB - E-Book