Thyroid Nodule In A Post-Partum Patient

Thyroid dysfunction is a relatively common occurrence during pregnancy, as well as in the first postpartum year. It is believed that this may be related to the changes that occur to the immunosuppressive system of the mother both during and after pregnancy . The discovery of a thyroid nodule in a postpartum patient requires proper diagnosis and treatment.

Approximately 5% to 10% of women suffer from Postpartum Thyroid Dysfunction. This dysfunction often involves both a hyperthyroid phase and a hypothyroid phase, and most patients will recover without treatment. The symptoms of both hyperthyroid and hypothyroid conditions can result in goiters and elevated TPO antibodies. Some patients will develop thyrotoxicosis, where the radioactive uptake function of the thyroid is suppressed. Again, many patients with this condition will recover spontaneously, and treatment by the use of beta-adrenergic blockers should only be used for symptomatic patients.

There are several diagnostic techniques used to determine if a thyroid nodule is potentially malignant. Surgical biopsies are sometimes used, though more recently the use of fine-needle aspiration has come to be considered a more effective approach. According to one study, the use of fine-needle aspiration was more than three times as effective at detecting malignancies than was a typical surgical biopsy. This study also determined that the use of fine-needle aspiration, while effective, is a technique that is more delicate than a typical surgical biopsy; it is more effective when done by an experienced practitioner.

Thyroid Imaging can also be used to detect problems with the thyroid gland. There are several different types of imaging techniques available; among them are radionuclide imaging, ultrasonography, computed tomography, and magnetic resonance imaging. A recent study has promoted the use of ultrasonography as being a safe and effective method of imaging the thyroid. Ultrasonography can help not just to find malignancies, but also to differentiate between more dangerous thyroid conditions and those that pose less risk to the patient. Besides being an effective method of imaging the thyroid, it is not contraindicated in the postpartum patient.

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