Congenital Hypothyroidism pptx

CONGENITAL HYPOTHYROIDISM
PRESENTED BY ..
MS. ANEETA SHARMA
NURSING LECTURER (CHILD HEALTH NURSING)
MS. ANEETA SHARMA

INTRODUCTION
 In the Fetus:-Before 12 weeks of pregnancy the fetal thyroid gland is not
fully developed so, the baby depends on the mother's thyroid hormones these
hormones cross the placenta from the mother to the baby.
 After 12 weeks the fetal thyroid gland starts working ,it begins making its own
thyroid hormones (T3 and T4)but it still relies on the mother for iodine, which
is needed to make these hormones.
 These hormones (primarily thyroxine [T4] and triiodothyronine [T3] are
essential for growth, development, and metabolism.
MS. ANEETA SHARMA

FUNCTIONS OF THE FETAL THYROID
GLAND
Growth and development, especially for the brain and nervous system.
Helps bones grow and mature during fetal development.
Regulates metabolism
Maintains body temperature
MS. ANEETA SHARMA

CONGENITAL HYPOTHYROIDISM
Congenital hypothyroidism is a condition present at birth in which
the thyroid gland is absent, underdeveloped, misplaced, or not
functioning properly, leading to insufficient thyroid hormone
production.
MS. ANEETA SHARMA

Congenital Hypothyroidism
↓
Thyroid gland is
absent / underdeveloped / misplaced / not functioning properly
↓
↓ Thyroid hormone production
↓
Hormone deficiency
↓
Affects brain development, growth, and metabolism (congenital
hypothyroidism )

DEFINITION
Congenital hypothyroidism (CH) is a thyroid hormone
deficiency(T3,T4) present at birth, leading to developmental and growth
delays if left untreated.
MS. ANEETA SHARMA

TYPES OF HYPOTHYROIDISM IN
CHILDREN
1-Congenital
Hypothyroidism
(CH)
2-Acquired
Hypothyroidism
MS. ANEETA SHARMA

1-Congenital Hypothyroidism (CH)-
•Present at birth
•Causes:-
Thyroid dysgenesis-
•Aplasia – thyroid gland is completely missing
•Hypoplasia – thyroid gland is too small
•Ectopic – thyroid is in the wrong place (not in the neck)
MS. ANEETA SHARMA

Dyshormonogenesis –
•The thyroid gland is present, but there’s a problem in making thyroid
hormone.
•It's usually due to genetic defects (TG)in the steps of hormone production.
Maternal iodine deficiency-
•If a pregnant mother lacks iodine, the baby can’t make enough thyroid
hormone.
•Or if the mother takes antithyroid drugs, they can block thyroid hormone
production in the baby.
•.
MS. ANEETA SHARMA

2-Acquired Hypothyroidism-
•Develops later in childhood or adolescence.
•Commonly caused by Hashimoto’s thyroiditis (autoimmune
thyroiditis).
•Other causes:-
• Iodine deficiency or excess
• Radiation therapy
• Surgery or injury to the thyroid
MS. ANEETA SHARMA

INCIDENCE
• Occurs in approximately 1 in 2,000 to 4,000 newborns globally.
•More common in females.
•Detected early through newborn screening programs.
MS. ANEETA SHARMA

CLINICAL FEATURES
H-Horse voice
Y- yellow skin
P-protruded tongue
O-Obesity
T-teeth are delayed
H-Hernia
Y-you have difficulty to feeding them
R-Rough skin
O-open fontanelle
I-idiotic look
D-Delayed milestone

CONTI….
1-Early signs (often subtle):-
•Prolonged jaundice
•Poor feeding
•Constipation
•Excessive sleepiness
•Cold extremities
•Hypotonia (floppy baby)
MS. ANEETA SHARMA

CONTI….
2-Later signs (if untreated):
•Puffy face
•Large tongue (macroglossia)
•Hoarse cry
•Dry skin
•Large fontanelles
•Umbilical hernia
•Delayed growth and development
MS. ANEETA SHARMA

DIAGNOSTIC EVALUATION
1. Newborn Screening Test
•Detect CH before symptoms appear.
•Typically done at 48–72 hours after birth via heel prick, Elevated TSH and/or low T4 suggest
hypothyroidism.
2.Thyroid Ultrasound
•Detects size, structure, and location of thyroid gland.
3.Radionuclide Thyroid Scan (Scintigraphy)
A special test using a tiny amount of safe radioactive medicine-Technetium-99m or Iodine-123.
Shows where the thyroid is and how well it works.
Helps find if the thyroid is missing, in the wrong place, or not working properly.
4. Serum Thyroid Antibodies
•Anti-TPO(Thyroid Peroxidase), TSH receptor antibodies (to check for maternal autoimmune disease).
MS. ANEETA SHARMA

MANAGEMENT
•Medical Management-
•Hormone Replacement:
Use Levothyroxine (thyroid hormone).
•Start treatment early, treatment should not be delayed.
•Dosage:
•Eltroxin (L-thyroxine)
•8–12 mg/kg/day → For brain (neurologic) development in newborns.
•Later: 4–8 mg/kg/day → For physical (somatic) growth.

Nursing Management
Nursing Assessment-
Check for signs and symptoms in the newborn.
Assess behavioral patterns (sleep, eating, alertness, school performance).
Monitor growth (weight, head size, growth rate).
Nursing Diagnosis-
Delayed Growth & Development – Due to low thyroid hormone.
Lack of Knowledge – Parents need education about the condition and treatment.
MS. ANEETA SHARMA

Nursing Interventions
Promote Growth and Development:
Monitor growth regularly.
Educate parents to give medicine daily.
If the pill is chewed:-Teach child not to brush teeth right after taking the
medicine.
Don’t mix medicine in a full bottle of milk baby might not finish it Instead, mix
with a small amount of liquid or food.
❌ Do not mix with soy formula
MS. ANEETA SHARMA

Parental Education
Regular Follow-up:
Parents should take the child for regular blood tests and
neurodevelopment assessments with a pediatrician or endocrinologist.
Lifelong Therapy:
Help the family understand that treatment with thyroid hormones (like
levothyroxine) is usually needed for life.
Early Support:
If there are signs of delayed mental development, refer the child for
special tests and therapies early.
MS. ANEETA SHARMA

CONTI….
Overdose Awareness:
Educate about the dangers of giving too much levothyroxine.
Signs of overdose:
◦Weight loss
◦Restlessness
◦Heat intolerance
◦Fatigue
◦Muscle weakness
◦Fast heartbeat (tachycardia)
MS. ANEETA SHARMA

MS. ANEETA SHARMA

Congenital Hypothyroidism pptx

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