[Physiology of the thyroid during pregnancy. Various exploratory tests]. 1989

J P Cappoen
Service d'Endocrinologie et Métabolismes, CHU, Lille.

In spite of frequent hypertrophy of the gland, the thyroid function remains normal during pregnancy. Of course, the total thyroid hormones level bound to TBG (Thyroxine Binding Globulin) increases regularly as a result of hyperestrogenism, but the level of the free fractions of the thyroid hormones (FT3, FT4) which is normal during the 1st trimester tends to decrease regularly during the 2nd and 3rd trimesters. There is a moderate decrease of the TSH level during pregnancy. The placenta plays a major role in the synthesis and metabolism of the thyroid function hormones. TSH, T3, T4 and thyroglobulin cannot cross the placental barrier while TRH, iodine, and thyrostimulating immunoglobins can. Among medications, thyroid hormones do not cross the placental barrier contrary to synthetic anti-thyroid preparations (SAT), lithium and beta-blockers. Therefore, this should be taken into consideration in the treatment of dysthyroidisms, knowing that the thyroid gland of the fetus becomes functional at 12 weeks: the secretion of fetal T4 and TSH is present as early as the 18-20th week. The thyroid gland of the fetus has no auto-regulation mechanism and the fetus adjust his hormone secretion according to the iodine environment.

UI MeSH Term Description Entries
D010920 Placenta A highly vascularized mammalian fetal-maternal organ and major site of transport of oxygen, nutrients, and fetal waste products. It includes a fetal portion (CHORIONIC VILLI) derived from TROPHOBLASTS and a maternal portion (DECIDUA) derived from the uterine ENDOMETRIUM. The placenta produces an array of steroid, protein and peptide hormones (PLACENTAL HORMONES). Placentoma, Normal,Placentome,Placentas,Placentomes
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013961 Thyroid Gland A highly vascularized endocrine gland consisting of two lobes joined by a thin band of tissue with one lobe on each side of the TRACHEA. It secretes THYROID HORMONES from the follicular cells and CALCITONIN from the parafollicular cells thereby regulating METABOLISM and CALCIUM level in blood, respectively. Thyroid,Gland, Thyroid,Glands, Thyroid,Thyroid Glands,Thyroids
D013963 Thyroid Hormones Natural hormones secreted by the THYROID GLAND, such as THYROXINE, and their synthetic analogs. Thyroid Hormone,Hormone, Thyroid,Hormones, Thyroid

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