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Specifics of treatment of thyroid diseases in pregnancy

Publication at First Faculty of Medicine |
2014

Abstract

Hypothyroidism is one the most common endocrinological disorders in women of the reproductive age. Based on foreign studies and studies done in Czech Republic almost 8% of pregnant women don't have optimal thyroid function and another 2-3% are at risk of thyroid dysfunction during pregnancy or developing postpartum thyroiditis.

Maternal thyroid dysfunction shows adverse impacts on pregnancy and on the new-born baby and the relevant therapy remedies or minimises such consequences. The diagnosis uses TSH (thyrotropin), TPOab (thyroid autoantibodies), FT4 (free thyroxine).

The scope of standards differs from the common population, being specific for individual trimesters. Hypothyroidism, including subclinical forms, should betreated vigourosly immediately when the diagnosis is done.

The laboratory test (TSH, eventually FT4) should be checked every 4-5th week until the19th week of gestation, after parturition and 2-3 months in order to detect the diagnosis of postpartum thyroiditis. The women already treated for hypothyroidism must usually increase the levothyroxin dose.

The treatment of thyrotoxicosis is necessary, propylthiouracyl for the first trimester is advisable and since the second trimester methimazol must be applied. There is an ongoing debate regarding the need for timely detection of thyroid dysfunction during pregnancy.