Postpartum thyroiditis

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 . It may also occur following a spontaneous or induced abortion.

Epidemiology

The estimated incidence is thought to be around 5-10% of postpartum women .

Clinical presentation

Patients may be either hyperthyroid or hypothyroid. Some patients may be initially hyperthyroid, later becoming hypothyroid. It typically occurs during the 1 year following childbirth.

Pathology

Associations
  • antithyroid peroxidase (anti-TPO) antibodies: although 50% of anti-TPO positive women may not develop thyroid dysfunction

Radiographic features

Ultrasound

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 .