title: Postpartum thyroid dysfunction in women with autoimmune thyroiditis.
abstract: BACKGROUND
  Autoimmune thyroiditis (AIT) is a predisposing factor for developing postpartum thyroid dysfunction (PPTD).
  
  
  OBJECTIVE
  To study the characteristics of PPTD in women with AIT.
  
  
  METHODS
  Thirty-eight women with pre-existing AIT were included in the study. Thyroid-stimulating hormone, free triiodthyronine, free thyroxine, thyroid peroxidase antibodies, thyroglobulin antibodies were measured and ultrasound evaluation of the thyroid gland was performed in the first trimester of pregnancy and during the first year following delivery.
  
  
  RESULTS
  Thyroid dysfunction was recognized in 68.4% of the patients - 28.9% presented with hypothyroidism and 39.5 % with thyrotoxicosis. The immunological and morphological parameters did not differ between euthyroid women and those with thyroid dysfunction. At the end of the postpartum period restoration of euthyroid state (being on the treatment before pregnancy) was observed in 15.4% of patients with PPTD, while 84.6% required increase of the levothyroxine dose. The analysis found a significantly lower volume of the thyroid gland, shorter duration of the disease, a lower dose of levothyroxine before and during gestation in patients with impaired thyroid function at the end of the postpartum period.
  
  
  CONCLUSIONS
  The risk of PPTD in women with AIT predating pregnancy is higher among women with preserved thyroid functional capacity motivating a thorough assessment of thyroid hormone levels and close follow-up of those women during the postpartum period.
authors.affiliation: a Department of Endocrinology and Metabolic Diseases , Medical University , Plovdiv , Bulgaria and.
authors.forename: Antoaneta
authors.initials: A
authors.lastname: Argatska
authors.affiliation: a Department of Endocrinology and Metabolic Diseases , Medical University , Plovdiv , Bulgaria and.
authors.forename: Boyan
authors.initials: B
authors.lastname: Nonchev
authors.affiliation: a Department of Endocrinology and Metabolic Diseases , Medical University , Plovdiv , Bulgaria and.
authors.forename: Maria
authors.initials: M
authors.lastname: Orbetzova
authors.affiliation: b Department of Obstetrics and Gynecology , Medical University , Plovdiv , Bulgaria.
authors.forename: Blagovest
authors.initials: B
authors.lastname: Pehlivanov
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D049590:Postpartum Period / Q000097:blood* / Q000276:immunology; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood / Q000276:immunology; D013954:Thyroglobulin / Q000276:immunology; D013960:Thyroid Function Tests; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000276:immunology / Q000503:physiopathology*; D013967:Thyroiditis, Autoimmune / Q000097:blood / Q000000981:diagnostic imaging / Q000276:immunology / Q000503:physiopathology*; D013971:Thyrotoxicosis / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood / Q000627:therapeutic use; D014284:Triiodothyronine / Q000097:blood
chemical_list: D001323:Autoantibodies; C006606:anti-thyroglobulin; D014284:Triiodothyronine; D013972:Thyrotropin; D013954:Thyroglobulin; D013974:Thyroxine
keywords: Autoimmune thyroiditis; postpartum; thyroid dysfunction