Goitrous Hypothyroidism

**12**

Inc.; 2000

*Goiter - Causes and Treatment*

[Accessed: 04 June 2019]

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s12262-015-1317-5

**15**

**Chapter 2**

**Abstract**

anti-Tg antibody.

**1. Introduction**

Autoimmune Basis of Sub Clinical

Effects of overt hypothyroidism on pregnancy outcomes and fetal development are well established and treatment protocol is reputable. Subclinical hypothyroidism poses a major health problem in pregnancy. Requirement of iodine increases in pregnancy as demand for synthesis of excess thyroid hormones is there during pregnancy. This is because of fetal dependency on maternal thyroid hormones till 12 weeks of gestation as fetal thyroid tissue is not matured enough to produce adequate hormones for the growing fetus. Hence, dietary iodine deficiency or intake of excess goitrogens in diet can be the major cause of overt and subclinical hypothyroidism in pregnancy. Apart from this autoimmune basis of overt and sub clinical hypothyroidism is also equally important in pregnant women. Data accumulating shows presence of antibodies like anti TPO antibody (anti thyroperoxidase antibody) and anti Tg antibody (anti thyroglobulin antibody) in pregnancy which is associated with increased prevalence of overt and sub clinical hypothyroidism and aggravation of the symptoms associated with it. Studies also document that pregnancy related complications are more prevalent in presence of these autoimmune antibodies. Hence, management of subclinical hypothyroidism in pregnancy also differs in positive and negative cases of anti TPO antibody and

Hypothyroidism in Pregnancy

**Keywords:** sub-clinical hypothyroidism, pregnancy, obstetric outcome, autoimmunity, anti thyroperoxidase antibody (anti TPO antibody), anti-thyroglobulin antibody (anti Tg antibody), assisted fertilization

thyroid hormones is known to affect the mother and the fetus adversely.

associated SCH cases due to their differences in management.

Subclinical hypothyroidism (SCH), frequently observed in pregnancy is defined as high TSH with normal T4 and T3 level. The growing fetus is entirely dependent on mother thyroid hormones in the first 12 weeks; hence, any abnormalities during this period should be detected early and preventive measures initiated as decreased

Presence of anti-TPO antibody is a major risk factor for progression to overt hypothyroidism. After widespread use of fortified Iodine rich food and extra supplementation of iodine in pregnancy, the knowledge and prevalence of autoimmune clinical and subclinical hypothyroidism with presence of various antibodies against thyroid tissues and metabolic factors gains more importance. Adverse obstetric and fetal outcomes particularly attributed to anti TPO antibodies makes its study even more clinically relevant. It is important to know the burden of anti-TPO antibody

*Prakruti Dash and Rajlaxmi Tiwari*
