Thyrotropin maternal

Devlieger R, Vanderlinden S, de Zegher F, Van Assche FA, Spitz B. Effect of antenatal thyrotropin-releasing hormone on uterine contractility, blood pressure, and maternal heart rate. Am J Obstet Gynecol 1997 177(2) 431-3. 

Use of thyrotropin-releasing hormone (TRH) as an adjunct to antenatal corticosteroids was thought to further accelerate fetal lung maturation. However, the Australian Collaborative Trial of Antenatal Thyrotropin-Releasing Hormone (ACTOBAT) study failed to show additional benefits from TRH 200 meg every 12 hours. The frequencies of RDS (relative risk [RR] 1.17, 95% Cl 1.00-1.36) and need for ventilation (RR 1.15, 95% Cl 1.01-1.31) were not reduced, and treatment was associated with maternal nausea, vomiting, and light-headedness. Of more concern was the 12-month follow-up report in which TRH treatment was associated with motor delays (OR 1.51, 95% Cl 1.11-2.05), sensory impairment (OR 2.00, 95% Cl 1.06-3.74), social delays (OR 1.41, 95% Cl 1.01-1.95), and severe neurodevelopmental impairment (OR 1.75, 95% Cl 1.07-2.87). At this point, antenatal TRH treatment cannot be advised. 

Figure 63.3 The figure shows the evolution of maternal thyroidal funotion. TSH, serum thyrotropin. fT4, serum free thyroxine. NSD, no signifioant differenoes.

The figure shows that a normal General Cognitive Index requires adequate maternal iodine nutrition conditions and a thyroid function. CGI, General Cognitive Index. UIE, urine iodine excretion. TSH, serum thyrotropin. 

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