Thyroid disease, both thyrotoxicosis and hypothyroidism, are associated with adverse pregnancy outcomes and poor fetal development, including neurocognitive outcomes. Given the importance of understanding physiology, changes during pregnancy, and management, ACOG has published recommendations to guide clinical decision-making. Universal TSH screening for thyroid disease in pregnancy is not recommended. Subclinical thyroid disease (abnormal TSH but normal free T4) does not require treatment. However, overt hyperthyroidism and hypothyroidism warrant further management.
Low TSH and Increased free T4
Note: Maternal antibodies found in Graves disease cross the placenta and are cleared slowly | Notify neonatology of maternal diagnosis as neonatal Graves disease may not present immediately following delivery
High TSH, Low Free T4
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