#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Importance of active screening for thyroid disorders in pregnant women


Authors: Z. Límanová;  E. Potluková
Authors place of work: III. interní klinika 1. LF UK a VFN Praha
Published in the journal: Prakt Gyn 2007; 11(3): 120-124

Summary

In active screening, up to 5% of pregnant women are found to have a thyroid disorder, mostly asymptomatic hypothyroidism. If left untreated, even a mild decrease of the thyroid function may have a negative impact on the course of pregnancy, as well as on the fetal development - mainly in the psychomotor area. In this article, we review the current opinions on active screening for thyroid disorders in pregnant women and in women who wish to conceive. Also, euthyroid women with positive antithyroid antibodies should be identified. Their thyroid function may alter significantly during pregnancy, and they commonly develop postpartum thyroiditis. The Czech Endocrinological Society recommends introducing a preventive examination of thyroid disorders in all women in early pregnancy, as a part of the first blood examination.

Key words:
thyroid disorders – pregnancy – screening – hypothyroidism – thyroid antibodies


Zdroje

1. Límanová Z, Zamrazil V. Má být zaveden screening funkčních tyreoidálních onemocnění u dospělých v České republice? DMEV 2004; 3: 124-129.

2. Casey BM, Dashe JS, Wells CE et al. Subclinical hypothyroidism and pregnancy outcomes. Obstet Gynecol 2005; 105(2): 239-245.

3. Idris I, Srinivasan R, Simm A et al. Maternal hypothyroidism in early and late gestation: effects on neonatal and obstetric outcome. Clin Endocrinol 2005; 63(5): 560-565.

4. Allan WC, Haddow JE, Palomaki GE et al. Maternal thyroid deficiency and pregnancy complications: implications for population screening: J Med Screen 2000; 7(3): 127-130.

5. Negro R, Formoso G, Mangieri T et al. Levothyroxine treatment in euthyroid pregnant women with autoimmune thyroid disease: effects on obstetrical complications. J Clin Metab 2006; 91(7): 2587-2591.

6. Haddow E, Palomaki GE, Allan W et al. Maternal thyroid deficiency during pregnancy and subsequent neuropsychosocial development of the child. N Engl J Med 1999; 341: 549-555.

7. Mitchell ML, Klein RZ. The sequelae of untreated maternal hypothyroidism. Eur J Endocrinol 2004; 151: U45-U48.

8. Burrow GN, Fisher DA, Larsen PR. Maternal and fetal thyroid function. N Engl J Med 1994: 331(16): 1072-1078.

9. Morreale de Escobar G, Obregon MJ, Escobar del Rey F. Role of thyroid hormone during early brain development: Eur J Endocrinol 2004; 151: U25-U37.

10. Utiger RD: Maternal hypothyroidism and fetal development. New Engl J Med 1999; 341: 601-602.

11. Ladenson PW, Singer PA, Ain KB et al. American Thyroid Association guidelines for detection of thyroid dysfunction. Arch Interim Med 2001; 160(11): 1573-1575.

12. Spencer C. Thyroid testing for the new millennium. Thyroid 2003; 13: 19-45.

13. Surks MI, Ortiz E, Daniels GH et al. Subclinical thyroid disease: scientific review and guidelines for diagnosis and management. JAMA 2004; 291(2): 228-238.

14. Wier FA, Farley CL. Clinical controversies in screening women for thyroid disorders during pregnancy. J Midwifery Womens Health 2006; 51(3): 152-158.

15. Vaidya B, Anthony S, Bilous M et al. Detection of thyroid dysfunction in early pregnancy: Universal screening or targeted high-risk case finding? J Clin Endocrinol Metab 2007; 92(1): 203-207.

16. Horacek J, Spitalnikova S, Cepkova J et al. Screening of autoimmune thyroid disorders in pregnancy in a highland district. Endocrine Abstracts 2006; 11: 881.

17. Špitálniková S, Horáček J, Pěkná E et al. Screening thyreopatií v těhotenství: DMEV 2005; 4.

18. Nohr SB, Jorgensen A, Pedersen KM et al. Postpartum thyroid dysfunction in pregnant thyroid peroxidase antibody-positive women living in an area with mild to moderate iodine deficiency: is iodine supplementation safe? J Clin Endocrin Metab 2000; 85(9): 3191-3198.

19. Sarvghadi F, Hedayati M, Mehrabi Y et al. Follow up of patients with postpartum thyroiditis: a population-based study: Endocrine 2005; 27(3): 279-282.

20. Premawardhana LD, Parkes AB, Ammari F et al. Postpartum thyreoiditis and long-term thyroid status: prognostic influence of thyroid peroxidase antibodies and ultrasound echogenicity. J Clin Endocrinol Metab 2000; 85(1): 71-75.

21. Lazarus JH. Thyroid disorders associated with pregnancy: etiology, diagnosis and management. Treat Endocrinol 2005; 4(1): 31-41.

22. Alexander EK, Marquesee E, Lawrence J et al. Timing and magnitude of increases levothyroxine requirements during pregnancyin women with hypothyroidism. N Engl J Med 2004; 351: 241-249.

Štítky
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#