1. Dra. Kelly Belen Ortiz
Residente Medicina Interna
Universidad del Norte - HUN

2. HIPOTALAMO
TRH
HIPOFISIS
TSH
T4/T3 TIROIDES

3. Estrogenos: > union hormonas Incremento en el metabolismo
tiroideas a TBG: Disminucion de tiroideo periferico: Segundo y
Hormona tiroidea libre: tercer trimestre, secundario a la
estimulando Eje Hipotalamo Deidodinasa 2 y 3 de la
Hipofisis Tiroides. placenta.
hCG y TSH: Subunidad alfa
identica, lo que estimula la
liberacion de T3 y T4. Por
retroalimentacion, se
disminuye la TSH en la semana
8- 14.

4. Valores T3/T4 T3i/T4i:
TSH Ajustado: Referenci
1.5 >. a según
trimestre.
Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American thyroid association and american
association of clinical endocrinologists. Endocrine practice vol 17 no. 3 may/june 2011

6. Supresion de la
TSH /hCG
Hipertiroidismo
Gestacional
Asx, primer
trimestre. No Mxs
GESTACION
Enfermedad
de Graves Antiroideos
Manifestaciones Clinicas: Falla en gano de peso, Intolerancia
al calor, sudor excesivo.
Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American thyroid association and american
association of clinical endocrinologists. Endocrine practice vol 17 no. 3 may/june 2011

7. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American thyroid association and american
association of clinical endocrinologists. Endocrine practice vol 17 no. 3 may/june 2011

8. MEDICAMENTOS CONSIDERACIONES
 TIANOMIDAS:  Todos los antitiroideos
Propiltiouracilo, Metimazol cruzan la barrera
y Carbimazol. placentaria y lactancia:
 Beta Bloqueadores: Hipotiroidismo fetal.
 Utilizar la dosis menor para
Propanolol alcanzar rangos seguros
maternos.
 Tianomidas:
Agranulocitosis
 Metimazol:
Malformaciones fetales
- Diagnosis and Management of Thyroid Disease in Pregnancy. Obstet Gynecol Clin N Am 37 (2010) 173–193
- Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American thyroid association and american
association of clinical endocrinologists. Endocrine practice vol 17 no. 3 may/june 2011

9. Contraindicacion
relativa
Gestacion
Tiroidectomia 2do Trimestre
No Rta /No uso
manejo medico.
Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American thyroid association and american
association of clinical endocrinologists. Endocrine practice vol 17 no. 3 may/june 2011

10.  I 131: Contraindicado durante la gestacion.
 No embarazarse 4-6 meses Postratamiento.
- Thyroid Emergencies. Med Clin N Am 96 (2012) 385–403.
- Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American thyroid association
and american association of clinical endocrinologists. Endocrine practice vol 17 no. 3 may/june 2011

11.  Exacerbacion aguda del hipertiroidismo.
 Fiebre, taquicardia, alteraciones
neurologicas.
 Desencadenantes: Preeclampsia, cirugias,
parto, infecciones.
Diagnosis and Management of Thyroid Disease in Pregnancy. Obstet Gynecol Clin N Am 37 (2010) 173–193

12. Thyroid Emergencies.
Med Clin N Am 96 (2012) 385–403.

13. Disminuir la produccion y liberacion
de T3/T4.
Disminuir los efectos perifericos de la
T4 y T3
Manejo de la descompensacion
sistemica y desencadenante
- Thyroid Emergencies. Med Clin N Am 96 (2012) 385–403.
- Diagnosis and Management of Thyroid Disease in Pregnancy. Obstet Gynecol Clin N Am 37 (2010) 173–193

14. Diagnosis and Management of Thyroid Disease in Pregnancy. Obstet Gynecol Clin N Am 37 (2010) 173–193

15. - Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American thyroid association and american
association of clinical endocrinologists. Endocrine practice vol 17 no. 3 may/june 2011

16. Vista desde la habitación de
Fernando Borrego.
Las Terrazas – Pinar Del Rio