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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...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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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. |
format | Online Article Text |
id | pubmed-9415345 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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