A -year-old woman, gravida , para , presents to the clinic for her initial prenatal visit at weeks gestation. She reports mild nausea and breast tenderness but otherwise feels well. She has no significant past medical history and takes only a daily prenatal vitamin. Her blood pressure is and pulse is . Physical examination reveals a normal-sized thyroid gland without palpable nodules or tenderness. Pelvic examination is consistent with an -week gestation. Routine initial prenatal laboratory studies are obtained, and the results of a reflexively drawn thyroid panel are as follows:
Thyroid-stimulating hormone (TSH): (Reference: )
Total thyroxine (T4): (Reference: )
Free thyroxine (T4): (Reference: )
Which of the following is the most appropriate next step in management?
- Reassurance and routine prenatal careAnswer
- BInitiation of propylthiouracil therapy
- CMeasurement of thyroid-stimulating immunoglobulins
- DInitiation of levothyroxine therapy
- EScheduling a thyroid ultrasonography