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What is Rani a 24-year-old woman presents to her gynaecologist as she has chronic hypothyroidism and wants to conceive now. Her hypothyroidism is well controlled at 75 microgram of Thyroxine. She doesn&;t smoke or drink and doesn&;t have any other medical ailment. She would like to know if she should keep taking her Thyroxin. Which of the following is the best advice to give to this patient? and explain in detail?
Hypothyroidism The woman is staed on 100microgm Thyroxine if she is not already on this hormone.The dose can then be increased in 2nd TM according to values noted.Once euthyroid thyroid function should be checked in each trimester.Following an adjustment of dosage the free thyroxine is checked after 4-6weeeks.The doses are adjusted until the TSH level is between .5 - 2.5 IU/ml.If the woman is already on thyroxine prior to pregnancy the dose will usually have to be increased by 25%as pregnancy is associated with an increase in thyroxine requirement. TEXTBOOK OF OBSTETRICS, SHEILA BALAKRISHNAN,Pg no:329,2nd edition