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Southern Ocean County Hospital would like to thank everyone who e-mailed questions for this edition of Ask-The-Expert and would like to especially thank Dr. Liu for taking part in the program.

May: Healthy Pregnancy

I have Hashimoto's thyroiditis. I have the goiter with pronounced nodules. I am monitored by an area ENT every six-months which includes ultrasounds of the thyroid. I take Levothyroxcin 25 mcg one time daily for control of my under activity.

My primary physician works closely with my ENT to monitor effectiveness of my medication. SO

My question(s) are:

Question 1
How would you monitor a woman who is pregnant with such a disease? knowing if the thyroid is not working properly it MAY cause slowed development in the fetus or defects as well as possible preterm delivery.

We would check thyroid function tests every four weeks to make sure that the level of Levothyroxcin is appropriate. If the level is appropriate, then the risks to the pregnancy should be minimal. I would also recommend you involve a high risk OB for follow-up care.

Question 2
Do you believe my monitoring by my physicians involved are sufficient?

Yes, while you are not pregnant.

Question 3
What methods for monitoring the fetal growth are you using to ensure everything is progressing normally?

Digital exams, fundal height measurement and serial ultrasound.

Question 4
What test are you aware of(blood)that are used on pregnant women other than a metabolic/thyroid panel?

Standard OB blood tests

My condition was missed, not purposely, by my primary and gynecologist because they agreed to run the thyroid and metabolic panels which always came back negative even though my thyroid was not healthy. It was diagnosed after a checkup revealed my neck to be twice its size. I was then put through everything including a needle biopsy.

Question 5
As for the baby after birth, Southern Ocean County Hospital uses the 30 multiple blood testings for many types of conditions, including thyroid. Would you emphasize to the pediatrician my baby could have hypothyroidisim at birth and be sure that test is done immediately?

You should be sure that the pediatrician knows your medical history. Based on your history, the pediatrician will perform any tests that he or she feel are appropriate.

I also have Type 1 (formerly called Juvenile)Diabetes which is under control. I know of the blood tests and monitoring needs for that.

Dr. Liu's answers are informational only and should not be used as a diagnosis or for treatment. Please talk to your physician about official diagnosis of your condition and treatment.