Management of Levothyroxine Dosing in Pregnant Patients with Severe Proteinuria

Clinical Context and Recommendations

• The presence of severe proteinuria (>5 g/24h) is associated with more severe neonatal outcomes and worse maternal outcomes, making optimal thyroid management critical, as recommended by the American Heart Association, based on evidence from Hypertension 1, 2

Postpartum Management

• Reassess proteinuria at 3 months postpartum, as persistent proteinuria may indicate underlying renal disease requiring ongoing thyroid monitoring, according to the European Society of Cardiology, as reported in a study 3