Abstract
Healthy endocrine function is vital for fertility, normal foetal growth and development, labour and delivery, and postnatal breast feeding. In disease states such as diabetes, attention must be given to preconception planning and management of concomitant issues through a pregnancy. Both hypoglycaemia and hyperglycaemia can be teratogenic, resulting in poor maternal and/or foetal outcomes.
Likewise, maternal thyroid function must be maintained in the euthyroid range to avoid significant foetal neural damage from hyper- or hypothyroidism. Monitoring and adjustments of thyroid replacement at each trimester are recommended to parallel increasing foetal requirements.
Pituitary dysfunction may become apparent during pregnancy as the gland enlarges. Prolactin levels will normally rise in response to rising oestrogen levels, but may also stimulate the growth of a prolactinoma. Hypothalamic-pituitary-adrenal dysfunction is uncommon, but may result for other dysfunctions.
Successful pregnancy outcomes require pre-pregnancy patient counselling, planning, and ongoing monitoring of patient responses. This continues through pregnancy and the post-partum period.
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Abbreviations
- CSI:
-
Continuous subcutaneous insulin infusion
- DM1:
-
Type I diabetes
- DM2:
-
Type 2 diabetes
- GDM:
-
Gestational diabetes
- HA1c:
-
Haemoglobin A1c
- hCG:
-
Human chorionic gonadotropin
- MDI:
-
Multiple daily injections
- MM:
-
Methimazole
- Mnt:
-
Medical nutrition
- PPT:
-
Post-partum thyroiditis
- PTU:
-
Propylthiouracil
- RAI:
-
Radioactive iodine
- SMBG:
-
Self-monitoring of blood glucose
- T3:
-
Tri-iodothyronine
- T4:
-
Thyroxine
- TRH:
-
Thyroid-releasing hormone
- TSH:
-
Thyroid-stimulating hormone
- TSI:
-
Thyroid-stimulating immunoglobin
- μg:
-
Micrograms
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Eckert-Norton, M., Hendricks, S. (2019). The Endocrine System and Pregnancy. In: Llahana, S., Follin, C., Yedinak, C., Grossman, A. (eds) Advanced Practice in Endocrinology Nursing. Springer, Cham. https://doi.org/10.1007/978-3-319-99817-6_42
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