Abstract
Postpartum thyroiditis (PPT) is defined as the de novo onset of thyroid dysfunction, excluding Graves’ disease (GD), in a previously euthyroid woman within the first year after delivery. The prevalence of PPT ranges between 5 and 10% in the general population. The incidence of PPT is higher in women with positive thyroid peroxidase antibodies (TPO-Ab) and in the presence of other autoimmune disorders like type 1 diabetes. PPT presents with vague symptoms which are often overlooked in the postpartum phase. The presentation includes a classic biphasic pattern (hyperthyroidism followed by hypothyroidism with return to euthyroid phase), isolated hyperthyroidism, and isolated hypothyroidism. The hyperthyroid phase is usually asymptomatic to mildly symptomatic, rarely requiring treatment. Differentiating the hyperthyroid phase of PPT from GD is important as PPT is treated only with beta-blockers, while GD requires anti-thyroid drugs. Symptoms of the hypothyroid phase are more pronounced and may require treatment with levothyroxine in subjects with PPT. Once diagnosed with PPT, if the patient reverts to euthyroid state, annual TSH follow is required, as up to 50% of these women progress to permanent hypothyroidism. There are no robust screening protocols for PPT, though testing is recommended in women with TPO-Ab positivity, autoimmune disorders and past history of PPT. No modality is validated for the prevention of PPT.
Authors’ contributions: SC has drafted the chapter. Both authors have reviewed and edited the final manuscript.
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Chandrasekaran, S., Rajandran, P. (2023). Postpartum Thyroiditis. In: Sagili, H., Sahoo, J., Chandrasekaran, S. (eds) Thyroid Disease in Pregnancy - A Guide to Clinical Management. Springer, Singapore. https://doi.org/10.1007/978-981-99-5423-0_8
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