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A tweetorial on hyperthyroidism during pregnancy.

Following yesterday's @ObsMedEd webinar on thyroid disease in pregnancy:

#MedTwitter #FirstTweetorial
Feedback and discussion more than welcome!

[Picture: neonatal Graves' disease] nejm.org/doi/full/10.10… Image
Hyperthyroidism occurs in 1%-2.2% of pregnancies, depending on the reference range you use.

Probably 95% of hyperthyroidism in pregnancy is physiological due to thyroid stimulation by hCG.

liebertpub.com/doi/abs/10.108…
academic.oup.com/clinchem/artic…
Figure from rdcu.be/uKOO Image
hCG --> high structural similarity with TSH --> weak binding affinity for TSH receptor (TSHr)
--> ~50% increase thyroid hormone production/secretion in pregnancy
--> negative feedback --> lower TSH --> (subclinical) hyperthyroidism
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