Could blood ketone monitoring be a tool for managing gestational diabetes mellitus?
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Adult↗
Biomedical subjects
Claudine Vasseur
Publications and source records attributed to Claudine Vasseur.
[Thyroid dysfunction and pregnancy].
The pregnancy is a state of thyroid hyperstimulation, therefore of changes of thyroid hormone values. Results of thyroid hormone measurement have to be analysed in the context of gestation age. Hyperthyroidism, mostly represented by Graves' disease, requires a multidisciplinary management, owing to possible maternal, foetal and neonatal complications. Treatment with antithyroid drugs, is a compromise between the risk of uncontrolled maternal hyperthyroidism and the risk of iatrogenic foetal hypothyroidism. Evaluation of foetal thyroid function considers the titre of thyrotropin receptor antibodies in the mother's blood, the dose of antithyroid drugs to maintain euthyroidism in the mother, and the signs of foetal hyperthyroidism on ultrasound. Maternal hypothyroidism is associated with foetal and maternal morbidity. Untreated or inappropriately treated, it is associated with poorer performances of offspring in intelligence tests. Thyroid autoimmunity is associated with hypofertility, particularly with spontaneous abortion. Screening for thyroid dysfunction during pregnancy, although not systematic, should have broad indications.
Antithyroid Agents↗
A chorionic gonadotropin-sensitive mutation in the follicle-stimulating hormone receptor as a cause of familial gestational spontaneous ovarian hyperstimulation syndrome.
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Adult↗
Abnormal stimulation of the thyrotrophin receptor during gestation.
Pregnancy induces physiological alterations in thyroid function which may make difficult the interpretation of results of thyroid hormone measurement. A state of hyperstimulation of the thyroid gland is common in early pregnancy. In a few cases, thyroid hormone values will deviate from the normal range, which corresponds to the gestational transient thyrotoxicosis. This syndrome is closely associated with hyperemesis gravidarum. The relationship between the two syndromes, demonstrated by epidemiological studies, has been illustrated by an exceptional case of familial recurrent gestational thyrotoxicosis presenting as hyperemesis gravidarum due to hypersensitivity of the thyrotrophin receptor to hCG. However, the exact mechanisms of hyperemesis gravidarum have not yet been identified. Gestational transient thyrotoxicosis has to be distinguished from Graves' disease, because the latter is associated with potential maternal and fetal complications when thyrotoxicosis is not controlled, whereas the former has usually a favourable outcome. The existence of other cases of thyroid hypersensitivity or hCG endowed with abnormal thyrotrophic activity is suspected. They may be identified only by assessment of the thyroid function in cases of hyperemesis gravidarum. The identification of these cases would be helpful to understand the mechanisms of specificity of glycoprotein hormone receptors.
Amino Acid Sequence↗