If symptomatic cases require treatment, a short course of beta-blockers would be effective.Assessing treatment for the hypothyroid is more complex. Women with symptoms or a very high TSH level, or both, are usually prescribed a course of levothyroxine. Asymptomatic women with slightly elevated TSH levels who are planning subsequent pregnancies, should consider a course of treatment until completion of the family to avoid possible developmental complications in future children. Otherwise, treatment could be discontinued after one year postpartum. Prevalence
Women with type I diabetes mellitus have a threefold increase in the prevalence of postpartum thyroiditis than non-diabetic women in the same region.According to Johns Hopkins, 3 in 100 women develop postpartum thyroiditis. Some risk factors include antithyroid antibodies, type 1 diabetes, history of thyroid problems, and family history of thyroid problems. According to the National Institute of Health, postpartum thyroiditis is especially common in Pakistan because it is an iodine-deficient country. References
Further reading
"Postpartum Thyroiditis." Johns Hopkins Medicine, www.hopkinsmedicine.org/health/conditions-and-diseases/postpartum-thyroiditis. Afzal, Rafia. "Thyroid disorders in pregnancy: An overview of literature from Pakistan." Indian journal of endocrinology and metabolism vol. 17,5 (2013): 943–5. doi:10.4103/2230-8210.117202
It is recommended that 20 mg of dinoprostone vaginal suppository be administered every three to five hours to evacuate the uterus. The abortion should occur within 24 hours after the beginning of administration of dinoprostone; if it does not, dinoprostone should no longer be given and other interventions would be required, such as dilation and curettage. Side effects
A common side effect of prostaglandin E2 is its effect on gastrointestinal smooth muscle resulting in nausea, vomiting and diarrhea. Other side effects include headache, shivering, and chills. The suppository form of prostaglandin E2 is associated with increased severity of these symptoms. Fever is also a common side effect with use of prostaglandin E2. Administration of prostaglandin E2 should be stopped if a person experiences side effects such as fever.The insert and gel forms have been shown to have minimal gastrointestinal effects, but are more associated with increase stimulation of the uterus as well as fetal distress. Uterine hyperstimulation is effectively treated by stopping use of prostaglandin E2. Other monitoring parameters include sustained uterine contractions and fetal distress. In babies there may be decreased breathing and low blood pressure. Care should be taken in people with asthma or glaucoma and it is not recommended in those who have had a prior C-section. Mechanism of action
Prostaglandin E2 binds to G protein-coupled receptors (GPCRs) EP1, EP2, EP3, and EP4 to cause various downstream effects to cause direct contractions in the myometrium.