Autoimmune thyroid disease in pregnancy: a review.
The maternal physiological changes that occur in normal pregnancy induce complex endocrine and immune responses. During a normal pregnancy, thyroid gland volume may enlarge, and thyroid hormone production increases. Hence, the interpretation of thyroid function during gestation needs to be adjusted according to pregnancy-specific ranges. The elevated prevalence of gestation-related thyroid disorders (10%-15%) and the important repercussions for both mother and fetus reported in multiple studies throughout the world denote, in our opinion, the necessity for routine thyroid function screening both before and during pregnancy. Once thyroid dysfunction is suspected or confirmed, management of the thyroid disorder necessitates regular monitoring in order to ensure a successful outcome. The aim of treating hyperthyroidism in pregnancy with antithyroid drugs is to maintain serum thyroxine (T(4)) in the upper normal range of the assay used with the lowest possible dose of drug, whereas in hypothyroidism, the goal is to return serum thyroid-stimulating hormone (TSH) to the range between 0.5 and 2.5 mU/L.
Galofre
Juan C
JC
Thyroid Research Unit, Mount Sinai School of Medicine, The Mount Sinai Hospital and the James J. Peters VA Medical Center, New York, New York, USA.
Davies
Terry F
TF
D000328:Adult; D013956:Antithyroid Agents / Q000627:therapeutic use; D005260:Female; D006111:Graves Disease / Q000175:diagnosis / Q000517:prevention & control; D006801:Humans; D006980:Hyperthyroidism / Q000175:diagnosis / Q000517:prevention & control; D007037:Hypothyroidism / Q000175:diagnosis / Q000517:prevention & control; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000517:prevention & control*; D011296:Prenatal Diagnosis / Q000379:methods; D012307:Risk Factors; D013959:Thyroid Diseases / Q000175:diagnosis* / Q000517:prevention & control*; D013960:Thyroid Function Tests; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D016387:Women's Health
D013956:Antithyroid Agents; D013972:Thyrotropin; D013974:Thyroxine