The Regulation of Thyroid Function in Pregnancy

The Regulation of Thyroid Function in Pregnancy: Pathways of Endocrine Adaptation from Physiology to Pathology
DANIEL GLINOER

Endocrine Reviews 1997 Vol. 18, No. 3 404-432

I. Introduction
II. The Regulation of Thyroid Function in Normal Pregnancy
A. The thyroid hormone transport proteins
B. The thyroid hormones
1. Total thyroid hormones
2. Free thyroid hormones
3. Peripheral metabolism of thyroid hormones
C. The serum levels of thyroglobulin (TG)
D. The metabolism of iodine
E. The hypothalamic-pituitary control of thyroid function
and the role of hCG
1. Hypothalamic-pituitary-thyroid axis (HPTA)
2. Regulation of serum TSH
3. Thyrotropic action of hCG
F. A global view of thyroidal economy in pregnancy
III. Pathological Alterations of Thyroidal Regulation Associated
with Pregnancy
A. IDD
1. Consequences of iodine deficiency during pregnancy
2. Assessment of increased thyroidal stimulation
3. Gestational goitrogenesis and its prevention by
iodine supplementation
4. Consequences of iodine deficiency for the offspring
B. Hypothyroidism and pregnancy
1. Fertility and pregnancy outcome in hypothyroid
women
2. Thyroid hormone replacement in the hypothyroid
pregnant woman
3. Subclinical hypothyroidism in pregnancy
4. Euthyroid autoimmune thyroid disorders
(AITD) and pregnancy
5. AITD and the risk of miscarriage
C. Hyperthyroidism and pregnancy
1. GD in the pregnant woman
2. GTT
3. Hyperemesis gravidarum and hyperthyroidism
IV. Conclusions and Perspectives