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Preconception Counseling in Patients with Hypothyroidism and/or Thyroid Autoimmunity

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...

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Autores principales: Țarnă, Mihaela, Cima, Luminița Nicoleta, Panaitescu, Anca Maria, Martin, Carmen Sorina, Sîrbu, Anca Elena, Barbu, Carmen Gabriela, Pavel, Bogdan, Șerbănică, Andreea Nicoleta, Fica, Simona
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9415345/
https://www.ncbi.nlm.nih.gov/pubmed/36013589
http://dx.doi.org/10.3390/medicina58081122
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author Țarnă, Mihaela
Cima, Luminița Nicoleta
Panaitescu, Anca Maria
Martin, Carmen Sorina
Sîrbu, Anca Elena
Barbu, Carmen Gabriela
Pavel, Bogdan
Șerbănică, Andreea Nicoleta
Fica, Simona
author_facet Țarnă, Mihaela
Cima, Luminița Nicoleta
Panaitescu, Anca Maria
Martin, Carmen Sorina
Sîrbu, Anca Elena
Barbu, Carmen Gabriela
Pavel, Bogdan
Șerbănică, Andreea Nicoleta
Fica, Simona
author_sort Țarnă, Mihaela
collection PubMed
description 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.
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spelling pubmed-94153452022-08-27 Preconception Counseling in Patients with Hypothyroidism and/or Thyroid Autoimmunity Țarnă, Mihaela Cima, Luminița Nicoleta Panaitescu, Anca Maria Martin, Carmen Sorina Sîrbu, Anca Elena Barbu, Carmen Gabriela Pavel, Bogdan Șerbănică, Andreea Nicoleta Fica, Simona Medicina (Kaunas) Review 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. MDPI 2022-08-18 /pmc/articles/PMC9415345/ /pubmed/36013589 http://dx.doi.org/10.3390/medicina58081122 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Țarnă, Mihaela
Cima, Luminița Nicoleta
Panaitescu, Anca Maria
Martin, Carmen Sorina
Sîrbu, Anca Elena
Barbu, Carmen Gabriela
Pavel, Bogdan
Șerbănică, Andreea Nicoleta
Fica, Simona
Preconception Counseling in Patients with Hypothyroidism and/or Thyroid Autoimmunity
title Preconception Counseling in Patients with Hypothyroidism and/or Thyroid Autoimmunity
title_full Preconception Counseling in Patients with Hypothyroidism and/or Thyroid Autoimmunity
title_fullStr Preconception Counseling in Patients with Hypothyroidism and/or Thyroid Autoimmunity
title_full_unstemmed Preconception Counseling in Patients with Hypothyroidism and/or Thyroid Autoimmunity
title_short Preconception Counseling in Patients with Hypothyroidism and/or Thyroid Autoimmunity
title_sort preconception counseling in patients with hypothyroidism and/or thyroid autoimmunity
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9415345/
https://www.ncbi.nlm.nih.gov/pubmed/36013589
http://dx.doi.org/10.3390/medicina58081122
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