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Peripartum Thyroiditis

Mark Stephens, MD MS and Allison Holmes, D.O. Reviewed 04/2024
 


BASICS

DESCRIPTION

  • Postpartum thyroiditis (PPT) is an autoimmune-mediated destructive thyroiditis occurring within 1 year after delivery or spontaneous/induced abortion in women who were euthyroid duri...

DIAGNOSIS

HISTORY

  • Fatigue, weight loss, irritability, palpitations, tremor, hyperhidrosis, heat intolerance, anxiety

  • Recently or currently pregnant

  • Painless swelling at anterior neck

PHYSICAL EXAM

Tachycar...

TREATMENT

GENERAL MEASURES

  • Most women become euthyroid within 1 year postpartum.

  • Initiate treatment for hyperthyroid symptoms once the diagnosis is confirmed  (1)[A]

  • Initiate treatment for hypothyroid st...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Follow-up TSH testing is indicated every 4 to 6 weeks during replacement therapy or with changes in symptoms.

  • Women with a prior history of PPT should have TSH tes...

REFERENCES

1
Yalamanchi  S, Cooper  DS. Thyroid disorders in pregnancy. Curr Opin Obstet Gynecol.  2015;27(6):406–415. [View Abstract on OvidMedline]
2
Al...

ADDITIONAL READING

Peng CCH, Pearce EN. An update on thyroid disorders in the postpartum period. J Endocrinol Invest. 2022;45(8):1497-1506. doi: 10.1007/s40618-022-01762-1. PMID: ...

SEE ALSO

Hyperthyroidism; Hypothyroidism, Adult; Thyroiditis 

CODES

ICD10

O90.5 Postpartum thyroiditis 

SNOMED

  • 10760041000119103 Thyroiditis in mother complicating childbirth

  • 10760381000119106 Thyroiditis in pregnancy

  • 52772002 Postpartum thyroiditis

CLINICAL PEARLS

  • TSH is the most sensitive measure of thyroid function in the peripartum period.

  • TSH may be elevated in the early gestational period due to high levels of hCG that may stimulate T4 produ...

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