Hamilelikte tiroid işlev bozukluğunun yönetilmesine dair kılavuz güncellendi…(İng)



Experts Update Guidelines on Managing Thyroid Dysfunction in Pregnancy

The Endocrine Society has updated its 2007 guidelines on managing thyroid disease immediately before, during, and after pregnancy.

Among the revisions, published in the Journal of Clinical Endocrinology and Metabolism:

  • Propylthiouracil (PTU) should be first-line treatment for hyperthyroidism in the first trimester; because of the potential for liver toxicity, patients should switch to methimazole for the later trimesters. Methimazole poses risk for congenital anomalies and should not be used in the first trimester unless PTU is unavailable or not tolerated.
  • Prenatal vitamins should contain 150-200 μg/day iodine, either potassium iodide or iodate.
  • Breast-feeding women should take 250 μg/day iodine.
  • Fine needle aspiration should be considered for pregnant women with nodules of 5 mm-1 cm with a high-risk history; complex nodules of 1.5-2 cm should be aspirated.

Consensus was not reached on thyroid screening of all newly pregnant women.

Journal of Clinical Endocrinology and Metabolism article (Free abstract)

Journal of Clinical Endocrinology and Metabolism editorial (Free)

Related story: Journal Watch Women’s Health summary of 2012 study not supporting prenatal screening (Your Journal Watch registration required)