Thyroid Disorders and Pregnancy: Diagnostic and Therapeutic Proposal

Abstract

Thyroid volume rises by 10–40 % during pregnancy and it depends on iodine deficiency. TSH concentration falls during pregnancy, especially in the first trimester, because hCG cross-react with TSH receptor. The lowest level is observed in 10 week pregnancy. In 10–20 % of pregnant women, in the first trimester, increased thyroid antibodies titer with normal TSH were found. There are no indications for antibody screening, however, TPO antibodies estimation should be considered in pregnant women in first trimester or those who are planning pregnancy. TSH screening should be regarded before and during pregnancy. Authors discuss in which clinical situation TPO antibodies and TRAb in serum can be estimated in pregnant women. Hyperthyroidism, hypothyroidism, and thyroid inflammation are characterized by specific clinical features, which concern diagnostic and therapeutical procedures, what is described in the article. Breastfeeding is not contraindicated in women treated for hyper- and hypothyroidism.