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Renal Disease in Pregnancy
  • Renal Disease in Pregnancy
  • 2nd edition
  • Edited by Kate Bramham, Matt Hall, Catherine Nelson-Piercy
  • Published online: 19 May 2018
  • Print publication: 24 May 2018
  • View description
    With higher risks to mother and baby in pregnant women with renal disease, critical decision-making is key. Giving practical guidance for antenatal, post-partum and maternity unit challenges, this book supports good practice and evidence-based management. The book includes evidence on antenatal and post-partum care; management of acute kidney injury in the delivery suite; and care guidelines for acute, chronic, and previously undiagnosed kidney diseases. The book also covers acute kidney injury, transplant, dialysis, pre-conception counselling, and medications. Previously published by RCOG, this revised edition includes:Updated expert consensus statementsComplete revision, with a new chapter on contraceptionUpdates in management of acute kidney injury, hypertension, dialysis and pregnancy, renal transplantation and pre-eclampsia.Structured to help clinicians make decisions, this book is for use by obstetricians, renal physicians, maternal medicine clinicians, midwives, urologists and specialist nurses.
  • Chapter 41 - Thyroid Disease in Pregnancy (Content last reviewed: 14th December 2020)
  • from Section 5 - Late Pregnancy – Maternal Problems
  • Edited by David James, University of Nottingham, Philip Steer, Imperial College London, Carl Weiner, University of Kansas, Bernard Gonik, Wayne State University, Detroit, Stephen Robson
  • Book: High-Risk Pregnancy
  • Published online: 15 November 2017, pp 1191-1216
  • View extract

    Summary

    Thyroid hormones play a crucial role during fetal development, and are especially important for growth and neurodevelopment in utero. The maternal physiological alterations that occur during pregnancy help regulate an adequate supply to the growing fetus, and pregnancy provides a “stress test” to the maternal thyroid gland. Thyroid disease is the second most common cause of endocrine dysfunction in women of childbearing age, after diabetes. Hypothyroidism is the more prevalent thyroid disorder, present in up to 2–5% of pregnancies, while hyperthyroidism (usually Graves’ disease) complicates another ~0.2%. It can often be challenging to diagnose and manage, because many of the symptoms of the disease are common symptoms in pregnancy. Physiological changes in pituitary and thyroid hormone levels may add complexity to the diagnosis, and a clear understanding of these changes is needed when managing women with suspected or known thyroid disease. The management of hypo- and hyperthyroid states is discussed in detail in this chapter, with an overview of thyroid cancer management.

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