Thyroid and pregnancy: A systematic review

Abstract

Pregnancy acts, like a stress test for the thyroid gland and results in hypothyroidism in women who are iodine deficient or have limited thyroid reserve, and postpartum thyroiditis in previously euthyroid women with underlying Hashimoto’s thyroiditis. However, there is inconclusive evidence to recommend for or against the universal serum TSH screening at the 1st trimester visit of a pregnant woman and trimester specific cut-off values should be used for monitoring the thyroid function (whenever performed). Nonspecific complaints, like irritability or anxiety in a postpartum lady should be investigated to rule out postpartum thyroiditis and not merely considered as maladjustment on the part of the lady. Thyroid nodules can grow in size during pregnancy but usually are well tolerated and can be operated postpartum. If deemed necessary during pregnancy, surgery should be carried out in the 2nd trimester for the same.