| Autor: |
Țarnă M; Department of Endocrinology and Diabetes, Nutrition and Metabolic Diseases-'Elias' Emergency University Hospital, 011461 Bucharest, Romania., Cima LN; Department of Endocrinology and Diabetes, Nutrition and Metabolic Diseases-'Elias' Emergency University Hospital, 011461 Bucharest, Romania.; Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania., Panaitescu AM; Department of Obstetrics and Gynecology Filantropia Clinical Hospital, 011171 Bucharest, Romania.; Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania., Martin CS; Department of Endocrinology and Diabetes, Nutrition and Metabolic Diseases-'Elias' Emergency University Hospital, 011461 Bucharest, Romania.; Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania., Sîrbu AE; Department of Endocrinology and Diabetes, Nutrition and Metabolic Diseases-'Elias' Emergency University Hospital, 011461 Bucharest, Romania.; Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania., Barbu CG; Department of Endocrinology and Diabetes, Nutrition and Metabolic Diseases-'Elias' Emergency University Hospital, 011461 Bucharest, Romania.; Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania., Pavel B; Department of Functional Sciences, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania., Șerbănică AN; Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.; Department of Pediatrics Hematology, Fundeni Clinical Institute, 022328 Bucharest, Romania., Fica S; Department of Endocrinology and Diabetes, Nutrition and Metabolic Diseases-'Elias' Emergency University Hospital, 011461 Bucharest, Romania.; Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania. |
| Abstrakt: |
Preconception counseling is an essential tool for preventing adverse pregnancy outcomes associated with thyroid dysfunction. The high prevalence of thyroid disease among women of reproductive age, and the increased risk of adverse pregnancy outcomes associated with thyroid dysfunction, emphasize the necessity for well-established screening and treatment criteria in the preconception period. We therefore conducted a literature review for relevant information on the screening, diagnosis and treatment of subclinical and overt hypothyroidism in women seeking pregnancy. While screening for thyroid disease is recommended only in the presence of risk factors, iodine supplementation should be recommended in most regions, with higher doses in areas with severe deficiency. Known hypothyroid women should be counseled about increasing their levothyroxine dose by 20-30% in the case of suspected or confirmed pregnancy (missed menstrual cycle or positive pregnancy test). Treating subclinical hypothyroidism appears to be beneficial, especially in the presence of autoimmunity or in patients undergoing artificial reproductive techniques. Regarding the management of TPOAb negative SCH women or euthyroid women with positive TPOAb, further research is necessary in order to make evidence-based recommendations. |
