Postpartum thyroiditis (PPT) is a type of thyroid inflammatory condition defined as the development of hypothyroidism, thyrotoxicosis or both in the year following childbirth in any women who did not have clinical evidence of thyroid disease before pregnancy 7. It may also occur following a spontaneous or induced abortion.
The estimated incidence is thought to be around 5-10% of postpartum women 3,7.
Patients may be either hyperthyroid or hypothyroid. Some patients may be initially hyperthyroid, later becoming hypothyroid. It typically occurs during the 1st year following childbirth.
- antithyroid peroxidase (anti-TPO) antibodies: although 50% of anti-TPO positive women may not develop thyroid dysfunction
Imaging investigation of choice. There may be a variable appearance with the thyroid gland often appearing hypoechoic.
Treatment and prognosis
It may last from several weeks to several months. The condition is usually transient. Some sources recommend annual thyroid function testing for 5-10 years in women with a history of postpartum thyroiditis due to their risk of developing permanent and overt hypothyroidism 7.
- 1. Adams H, Jones MC, Othman S et-al. The sonographic appearances in postpartum thyroiditis. Clin Radiol. 1992;45 (5): 311-5. Pubmed citation
- 2. Premawardhana LD, Parkes AB, Ammari F et-al. Postpartum thyroiditis and long-term thyroid status: prognostic influence of thyroid peroxidase antibodies and ultrasound echogenicity. J. Clin. Endocrinol. Metab. 2000;85 (1): 71-5. doi:10.1210/jcem.85.1.6227 - Pubmed citation
- 3. Lazarus JH. Clinical manifestations of postpartum thyroid disease. Thyroid. 1999;9 (7): 685-9. Pubmed citation
- 4. Parkes AB, Othman S, Hall R et-al. Role of complement in the pathogenesis of postpartum thyroiditis: relationship between complement activation and disease presentation and progression. Eur. J. Endocrinol. 1995;133 (2): 210-5. Pubmed citation
- 5. Lazarus JH. Thyroid disorders associated with pregnancy: etiology, diagnosis, and management. Treat Endocrinol. 2005;4 (1): 31-41. Pubmed citation
- 6. Barca MF, Knobel M, Tomimori E et-al. Prevalence and characteristics of postpartum thyroid dysfunction in São Paulo, Brazil. Clin. Endocrinol. (Oxf). 2000;53 (1): 21-31. Pubmed citation
- 7. Abalovich, Marcos, Amino, Nobuyuki, Barbour, Linda A., Cobin, Rhoda H., De Groot, Leslie J., Glinoer, Daniel, Mandel, Susan J., Stagnaro-Green, Alex. Management of Thyroid Dysfunction during Pregnancy and Postpartum: An Endocrine Society Clinical Practice Guideline. (2007) The Journal of Clinical Endocrinology & Metabolism. 92 (8_supplement): s1. doi:10.1210/jc.2007-0141
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