Hypertension, Preeclampsia, Birth Intervals after C-Section, Prior Preterm Birth, & Pre-existing Thyroid Disease
- Episode Written By : Kyla Freeman, Rural Family Medicine PGY2
- Episode Reviewed By : Dr. Megan Cuthbertson
- Hosts : Kyla Freeman, Patricia Massel, Catilin Blewett
- Episode Art : Aikansha Chawla
In this episode we hope to provide a brief overview of a few topics to consider in pre-conception and first pregnancy appointment counselling to help optimize your patients prenatal care. Topics we will explore include which antihypertensives are safe in pregnancy, who to consider starting on ASA early in pregnancy, how long to delay pregnancy post-C-section in patient’s wishing to have a TOLAC, interventions to help reduce the risk of preterm birth, and considerations when managing a pregnant patient with a past history of thyroid
Useful Websites and Resources
- Transcare BC Website http://www.phsa.ca/transcarebc
- Thyroid Disease in Pregnancy (including table of normal values for TSH, T4,T3) https://www.departmentofmedicine.com/endocrinology/endo-clinics/endo-endocrine-pathways/endo-thyroid-function-pregnancy/
- American College of Obstetricians and Gynecologists [ACOG]. Thyroid disease in pregnancy : ACOG practice bulletin, Number 223. 2020. 135(6), e261-e274. doi: 10.1097/AOG.0000000000003893
- American Thyroid Association. Thyroid disease during pregnancy. 2017. Retrieved from http://eguideline.guidelinecentral.com/i/789888-thyroid-disease-during-pregnancy/0? Accessed June 23, 2021.
- Deshauer S, Wyne A. Subclinical hypothyroidism in pregnancy. CMAJ. 2017. 189(28): E941. doi: 10.1503/cmaj.161388
- Dugan, Joy A. “Managing thyroid disease in pregnancy.” Clinician Reviews, vol. 25, no. 4, 2015, p. 20+. Gale Health and Wellness, link.gale.com/apps/doc/A411614115/HWRC?u=ucalgary&sid=bookmark-HWRC&xid=b0bea010. Accessed 2 June 2021.
- Society of Obstetricians and Gynecologists of Canada [SOGC]. Hypertensive Disorders of Pregnancy. In: Course manual: Advances in labour and risk management. 27th ed. Canada. SOGC; 2020-2021: 382 – 418.
- Society of Obstetricians and Gynecologists of Canada [SOGC]. Preterm Labour and Preterm Birth. In: Course manual: Advances in labour and risk management. 27th ed. Canada. SOGC; 2020-2021: 419 – 444.
- Society of Obstetricians and Gynecologists of Canada [SOGC]. Trial of Labour After Caesarean. In: Course manual: Advances in labour and risk management. 27th ed. Canada. SOGC; 2020-2021: 276 – 290.
- Sutander, M, Garcia-Bournissen, F, & Koren, G. Hypothyroidism in pregnancy. JCOG. 2007. 29(4). 354-356. Online. https://www-clinicalkey-com.ezproxy.lib.ucalgary.ca/service/content/pdf/watermarked/1-s2.0-S1701216316324379.pdf?locale=en_US&searchIndex=
- Toward Optimized Practice (TOP) Endocrine Working Group. Investigation and management of primary thyroid dysfunction clinical practice guideline. April 2014. Edmonton, AB: Toward Optimized Practice. Available from: http://www.topalbertadoctors.org