28 weeks pregnant TSH receptor antibody test

[hugs84]

Hi. I am currently 28 weeks pregnant. After the birth of son I developed post partum thyroiditis that after 7 months this changed to Hypothyroidism. And due to my nan and sisters having g Hashimotos it's suggested that I do aswell.

I have taken Thyroxine since then. (Currently 75mcg daily since 15 weeks of this current pregnancy, my second).

I am under the care of the endocrine clinic at Addenbrookes. I saw the consultant at around 15 weeks and had blood tests with the following results and diagnosis:

"Anti-TPO 3125, TRAB negative; TSH 1.3, FT4 15.8 .... the patient has a strongly positive anti-TPO test and family history of Hashimotos thyroiditis. Accordingly it is quite likely that the hypothyroidism is permanent.

She is now on optimal thyroxine replacement during her second pregnancy. An anti-TSH receptor antibody test is negative currently and if it stays that way when repeated at 28 weeks,the chances of foetal or neonatal thyroid problems are negligible."

Has anyone had a similar experience or have knowledge of this test and child screening?

What is the likelihood that this test could be positive and my child develop either thyroid condition?

How will I be monitored or my anti/neo natal care differ if this is found to be the case,and the blood tests are positive?

The midwife had been trying to convince me to have a home birth due to my first labour being under 2 hours. Will this still be possible or will I have to give birth in hospital?

How/will my child be screened for either thyroid conditions at birth? Is this possible with a home birth??

My blood tests are on Monday, I don't see the midwife until 7h August (due to this being my second pregnancy, the appointments are few and far between) I then see the thyroid consultant for the results on 10th August but will be dying with stress until then.

Thanks in advance x

[PinkNinja]

You can always phone a community midwife if you are concerned. They may be able to fit you in earlier to discuss what the doctor has said.

All babies are checked for hypothyroidism at birth through the heel-prick test. This should still happen if you have a home birth because the midwife can do it. Even if there is no midwife at the birth (if it's too quick), she would be able to do the test when she does see you. If you are concerned about any of this please do talk to a midwife. It is not like you are being neurotic: you have a chronic health condition and as such have a right to be concerned and to know how it will be handled.

All the best

Carolyn x

[hugs84 in reply to PinkNinja]

Thanks. Unfortunately I do t have a direct dial number for my community midwife, only for the clinics and would have to leave a message with the receptionist.

I've been reading through other threads on here,and I'm confused. Are tsh receptor antibody tests always to diagnose graves only? I am under active with hashimotos. I thought graves was hyper not hypo.

[PinkNinja in reply to hugs84]

This test is done if a pregnant woman has autoimmune thyroid disease whether it is Grave's or Hashimoto's. It's just a precaution to indicate the likelihood of the baby having thyroid disease at birth.

Have a look at this link. You may need to scroll down to the table. The bit about pregnancy screening is just under the table. The official test name is TRAb.

labtestsonline.org.uk/under...

I hope that helps.

[hugs84]

That's great. Thanks for that. So.much to take in!! X

[mistydog]

Not an expert in this at all, but my thoughts are that if the baby had thyroid problems they wouldn't be immediately obvious at birth or of immediate danger and therefore the home birth would make no difference to him/her, so go with your gut.

As I say, no expert.

[hugs84]

I was just wondering does anyone know what the ranges are for the anti-TPO test in the uk?

I know I read somewhere that the high end is between 25-35, but that it's not uncommon for results of 1000 or so In those diagnosed with hashimotos ( like me).

My results read : Anti-TPO titre 3125 (elevated)

Which seems phenomenally high!

what does this mean/signify?????

[helvella in reply to hugs84]

hugs84,

There is no UK range. The reference ranges vary considerably from one lab to another. You have to use the range from the lab that did your test.

Further, it has been said that the labs often simply stop going through their testing procedures once a very high number has been reached. So whilst 3125 might be very high, at another lab they might have stopped when is was over 1000.

[hugs84 in reply to helvella]

Oh ok. I knew it differed from lab to lab, but the only range info I could find was U.S based. Sadly I do t know the range for the lab that process my bloods (addenbrookes) but if what you say is true than the exact figure is irrelevant anyway... High is high etc.

I wonder why they don't all just use the same range? Seems ridiculous!!

[helvella in reply to hugs84]

Don't let it be sadly so. See if the information is on the internet - many labs post this sort of information. Or ring them up and ask. If needed, use the hospital PALS service to find out.

But, at the end, high is high.