Monitoring of Thyroid Malfunction and Therapies in Pregnancy and the Postpartum Period: A Systematic Updated Critical Review of the Literature
| Autor: | Heinz G Bohnet |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Thyroid Hormones
Thyroiditis endocrine system medicine.medical_specialty endocrine system diseases MEDLINE Thyroid Function Tests Hyperthyroidism 030226 pharmacology & pharmacy Thyroid function tests Human chorionic gonadotropin Selenium 03 medical and health sciences 0302 clinical medicine Antithyroid Agents Hypothyroidism Pregnancy Reference Values medicine Humans Pharmacology (medical) Intensive care medicine Pharmacology medicine.diagnostic_test business.industry Postpartum Period Thyroid medicine.disease Iodine deficiency Pregnancy Complications medicine.anatomical_structure Female business Postpartum period Iodine Hormone |
| Zdroj: | Therapeutic Drug Monitoring. 42:222-228 |
| ISSN: | 0163-4356 |
| DOI: | 10.1097/ftd.0000000000000691 |
| Popis: | Purpose From the very beginning of pregnancy, the maternal thyroid has to adapt to increased thyroid hormone secretion of up to 50%. This is paralleled by changes in thyroid-stimulating hormone secretion and by the thyroid-topic action of human chorionic gonadotropin. Thus, hypothyroidism and hyperthyroidism may occur. Many women exhibit preexisting thyroid diseases. This review tries to add the most recently published approaches to diagnosing thyroid malfunction in pregnancy to existing guidelines. Methods Different literature-based approaches to diagnosing thyroid malfunction during pregnancy and the postpartum period were applied. To diagnose thyroid malfunction in pregnancy, trimester-specific reference ranges for thyroid-stimulating hormone and T4 are used. Results Definitions of thyroid malfunction are given. Treatment schedules for various thyroid diseases were reviewed and, on the basis of recent findings, were revised where necessary. For a daily clinical workup, this outline not only suggests diagnostic and therapeutic steps but also refers to frequent pitfalls and misinterpretations of laboratory data. Conclusions Although the body of knowledge is increasing rapidly, the authors believe that this review is able to present new ideas concerning diagnostic and therapeutic tools for thyroid malfunction in pregnancy and the postpartum period. Nevertheless, there seems to remain room for individual approaches based on the personal experience of physicians who deal with these issues regularly. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|