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Peripartum Thyroiditis

Eddie Nance, MD, MS and Vanessa W. McNair, MD, MPH Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Postpartum thyroiditis (PPT) is an autoimmune-mediated destructive thyroiditis occurring within 1 year after delivery or spontaneous/induced abortion. It manifests as transient hyper...

DIAGNOSIS

HISTORY

  • Fatigue, weight loss, irritability, palpitations, tremor, hyperhidrosis, heat intolerance, anxiety (1)

  • Recently or currently pregnant

  • Painless swelling at anterior neck

PHYSICAL EXAM

Tach...

TREATMENT

GENERAL MEASURES

  • Most women become euthyroid within 1 year postpartum.

  • Treatment of hyperthyroid state should be initiated once the diagnosis is confirmed and the patient is symptomatic (3)[A]...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Follow-up TSH testing is indicated every 4 to 6 weeks during replacement therapy or with changes in symptoms (1).

  • Continued monitoring until 12 months postpartum i...

REFERENCES

1
Argatska AB, Nonchev BI. Postpartum thyroiditis. Folia Med (Plovdiv).  2014;56(3):145–151. [View Abstract on OvidMedline]
2
Pearce EN. Thyroid disorders during pregnancy and postpartum....

SEE ALSO

Hyperthyroidism; Hypothyroidism, Adult; Thyroiditis 

CODES

ICD10

O90.5 Postpartum thyroiditis 

ICD9

  • 648.1 Thyroid dysfunction complicating pregnancy

  • 648.14 Thyroid dysfunction complicating pregnancy

  • 648.13 Thyroid dysfunction complicating pregnancy

  • 648.12 Thy...

CLINICAL PEARLS

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

  • Free T4 is affected due to increased thyroxine-binding globulin secondary to increased estrogen productio...

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