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Endocrine disease in pregnancy 

Endocrine disease in pregnancy
Chapter:
Endocrine disease in pregnancy
Author(s):

David Carty

DOI:
10.1093/med/9780198746690.003.0273
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date: 02 March 2021

During pregnancy, there are several diseases of the endocrine system that can affect women. This chapter looks at a few of these. Many pregnant women will develop goitre. Gestational thyrotoxicosis needs to be differentiated from Grave’s disease, which requires treatment with propylthiouracil in early pregnancy and carbimazole in later pregnancy. Overt hypothyroidism is associated with adverse maternal and fetal outcomes and should be treated to maintain thyroid-stimulating hormone within the trimester-specific reference range. The diagnosis of both Addison’s disease and Cushing’s syndrome can be challenging in pregnancy. Patients with adrenal insufficiency require higher replacement steroid doses in the first and third trimesters. Prolactinomas are commonly encountered in pregnancy, with dopamine agonists the treatment of choice. Women with macroprolactinomas should have visual field monitoring throughout pregnancy. Lymphocytic hypophysitis is increasingly recognized as a cause of hypopituitarism arising in late pregnancy and in the post-partum period.

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