Maternal thyroid hormones play a foundational role in early placental development and fetal neurocognitive outcomes, yet diagnosing thyroid dysfunction during gestation is uniquely challenging. Markedly increased thyroid-binding globulin (TBG), altered renal clearance of iodine, and cross-reactivity between elevated hCG and TSH receptors fundamentally alter normal maternal biochemistry, frequently leading to misinterpretation of standard laboratory panels.In this practical masterclass, Dr. Pankaj Ferwani untangles the clinical complexities of maternal thyroid disorders. Moving beyond generic reference ranges, the session addresses the core dilemmas clinicians face: navigating trimester-specific TSH cutoffs, understanding the prognostic significance of anti-TPO antibody status, and deciding when to treat the contested territory of subclinical hypothyroidism. Clinicians will gain a clear, evidence-based roadmap for immediate levothyroxine dosing, proactive titration schedules, antenatal monitoring intervals, and safe postpartum dose adjustments