{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T14:40:59Z","timestamp":1769784059355,"version":"3.49.0"},"reference-count":12,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"vor","delay-in-days":28,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["AJP Rep"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Thyroid storm is a rare, life-threatening endocrine emergency in pregnancy with significant maternal and neonatal implications. Clinical symptoms may mimic those of hypertensive disorders in pregnancy. Prompt diagnosis and multidisciplinary management are critical for reducing maternal and neonatal morbidity and mortality.<\/jats:p>\n                  <jats:p>A 31-year-old woman with a dichorionic diamniotic twin pregnancy, chronic hypertension, short cervix, and poorly controlled Graves' disease presented at 22 weeks' gestation with vaginal bleeding and severe-range blood pressures. She was diagnosed with thyroid storm and admitted to the intensive care unit. She failed to respond to maximal medical management, ultimately requiring plasmapheresis. She later developed preterm labor and spontaneously delivered periviable twins. She eventually underwent total thyroidectomy for definitive management of thyroid storm.<\/jats:p>\n                  <jats:p>This case illustrates the severe consequences of poorly controlled Graves' disease in pregnancy. Although thyroid storm can mimic preeclampsia, abnormal thyroid function tests, persistent tachycardia, fevers, and hypertension with wide pulse pressures may help distinguish it. Timely recognition and multidisciplinary care are imperative to decrease morbidity and mortality associated with thyroid storm.<\/jats:p>","DOI":"10.1055\/a-2788-1788","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:11:46Z","timestamp":1769731906000},"page":"e30-e35","source":"Crossref","is-referenced-by-count":0,"title":["Thyroid Storm in a Twin Pregnancy Presenting as Severe Hypertension and Preterm Labor"],"prefix":"10.1055","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8682-5287","authenticated-orcid":false,"given":"Adwoa A.","family":"Baffoe-Bonnie","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine, Durham, North Carolina, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lillian J.","family":"Dubiel","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lillian B.","family":"Boettcher","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Martinez","family":"Cruz","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Internal Medicine, Duke University School of Medicine, Durham, North Carolina, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9147-7119","authenticated-orcid":false,"given":"Amanda M.","family":"Craig","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2026,1,29]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"crossref","first-page":"e261","DOI":"10.1097\/AOG.0000000000003893","article-title":"Thyroid disease in pregnancy: ACOG Practice Bulletin, Number 223","volume":"135","author":"Thyroid Disease in Pregnancy","year":"2020","journal-title":"Obstet Gynecol"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"74","DOI":"10.4037\/ccn2004.24.2.74","article-title":"Thyroid storm during pregnancy. A medical emergency","volume":"24","author":"P A Waltman","year":"2004","journal-title":"Crit Care Nurse"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/S2213-8587(13)70086-X","article-title":"Hyperthyroidism in pregnancy","volume":"1","author":"D S Cooper","year":"2013","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/S0889-8529(18)30165-8","article-title":"Life-threatening thyrotoxicosis. Thyroid storm","volume":"22","author":"H B Burch","year":"1993","journal-title":"Endocrinol Metab Clin North Am"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"450","DOI":"10.3390\/medicina58030450","article-title":"Thyroid storm superimposed on gestational hypertension: a case report and review of literature","volume":"58","author":"Y H Chen","year":"2022","journal-title":"Medicina (Kaunas)"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s13044-024-00190-y","article-title":"Thyroid storm in pregnancy: a review","volume":"17","author":"V Vadini","year":"2024","journal-title":"Thyroid Res"},{"issue":"04","key":"ref7","first-page":"366","article-title":"Clinical review and update on the management of thyroid storm","volume":"119","author":"R De Almeida","year":"2022","journal-title":"Mo Med"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"6298137","DOI":"10.1155\/crie\/6298137","article-title":"An Unusual and severe thyrotoxicosis in a twin pregnancy: fortune favors the brave","volume":"2025","author":"V Maltese","year":"2025","journal-title":"Case Rep Endocrinol"},{"issue":"03","key":"ref9","doi-asserted-by":"crossref","first-page":"e9606","DOI":"10.1097\/MD.0000000000009606","article-title":"Impending thyroid storm in a pregnant woman with undiagnosed hyperthyroidism: a case report and literature review","volume":"97","author":"Y Ma","year":"2018","journal-title":"Medicine (Baltimore)"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"m3320","DOI":"10.1136\/bmj.m3320","article-title":"Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis","volume":"370","author":"J Allotey","year":"2020","journal-title":"BMJ"},{"issue":"03","key":"ref11","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1177\/1751143714559910","article-title":"Thyroid storm causing placental abruption: cardiovascular and management complications for the Intensivist","volume":"16","author":"A S Lane","year":"2015","journal-title":"J Intensive Care Soc"},{"issue":"06","key":"ref12","first-page":"946","article-title":"Low birth weight and preeclampsia in pregnancies complicated by hyperthyroidism","volume":"84","author":"L K Millar","year":"1994","journal-title":"Obstet Gynecol"}],"container-title":["American Journal of Perinatology Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2788-1788.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:11:48Z","timestamp":1769731908000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2788-1788"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":12,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2026,1,14]]},"published-print":{"date-parts":[[2026,1]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2788-1788","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2157-6998","2157-7005"],"issn-type":[{"value":"2157-6998","type":"print"},{"value":"2157-7005","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]}}}