Thyroid disorders in pregnancy
Current Topics in Perinatology and Neonatology, NOVA Publications , ss.53-66, 2023
- Yayın Türü: Kitapta Bölüm / Araştırma Kitabı
- Basım Tarihi: 2023
- Yayınevi: NOVA Publications
- Sayfa Sayıları: ss.53-66
- Anahtar Kelimeler: Hyperthyroidism, Hypothyroidism, Pregnancy, Thyroid disorders
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Thyroid disorders during pregnancy are prevalent and associated with an increased risk of maternal and fetal adverse outcomes. They are commonly asymptomatic, or clinical symptoms are similar to nonspecific symptoms seen in normal pregnancy, so the diagnosis is difficult and requires understanding the changes in thyroid physiology. The appropriate management of overt thyroid diseases is crucial for both mother and the fetus. Hashimoto's thyroiditis is the most common cause of hypothyroidism during pregnancy in iodine-sufficient regions. Thyroid hormone replacement therapy is recommended in patients with overt hypothyroidism and thyroid autoantibody positive subclinical hypothyroidism. Graves' disease and hCG-mediated hyperthyroidism are the most common causes in hyperthyroid pregnant women. Women with moderate to severe symptoms due to overt hyperthyroidism require treatment and anti-thyroid drugs (thionamides) are used considering their side effects. There is an increased iodine requirement during pregnancy, and adequate iodine uptake is essential especially for fetal neurophysiological development. The incidence of thyroid nodules and cancer is also increasing in reproductive age, so if sonographic indications for biopsy occur, a fine needle aspiration biopsy can be performed safely during pregnancy. Management of the thyroid disease in the preconceptional period and during pregnancy should be done efficiently and monitoring of thyroid function continue in the postpartum period.