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Management of thyroid diseases during pregnancy
Authors:Hubalewska-Dydejczyk Alicja  Lewiński Andrzej  Milewicz Andrzej  Radowicki Stanisław  Poręba Ryszard  Karbownik-Lewińska Małgorzata  Kostecka-Matyja Marta  Trofimiuk-Müldner Małgorzata  Pach Dorota  Zygmunt Arkadiusz  Bandurska-Stankiewicz Elżbieta  Bar-Andziak Ewa  Bednarczuk Tomasz  Buziak-Bereza Monika  Drews Krzysztof  Gietka-Czernel Małgorzata  Górska Maria  Jastrzębska Helena  Junik Roman  Nauman Janusz  Niedziela Marek  Reroń Alfred  Sworczak Krzysztof  Syrenicz Anhelli  Zgliczyński Wojciech
Affiliation:Department of Endocrinology, Jagiellonian University, Medical College, Krakow, Poland. alahub@cm-uj.krakow.pl
Abstract:The management of thyroid disorders during pregnancy is one of the most frequently disputed problems in modern endocrinology. It is widely known that thyroid dysfunction may result in subfertility, and, if inadequately treated during pregnancy, may cause obstetrical complications and influence fetal development. The 2007 Endocrine Society Practice Guideline endorsed with the participation of the Latino America Thyroid Association, the American Thyroid Association, the Asia and Oceania Thyroid Association and the European Thyroid Association, greatly contributed towards uniformity of the management of thyroid disorders during pregnancy and postpartum. Despite the tremendous progress in knowledge on the mutual influence of pregnancy and thyroid in health and disease, there are still important areas of uncertainty. There have been at least a few important studies published in the last 3 years, which influenced the thyroidal care of the expecting mother. It should also be remembered that guidelines may not always be universally applied in all populations with different ethnical, socio-economical, nutritional (including iodine intake) background or exposed to different iodine prophylaxis models. The Task Force for development of guidelines for thyroid dysfunction management in pregnant women was established in 2008. The expert group has recognized the following tasks: development of the coherent model of the management of thyroid dysfunction in pregnant women, identification of the group of women at risk of thyroid dysfunction, who may require endocrine care in the preconception period, during pregnancy and postpartum - that is in other words, the development of Polish recommendations for targeted thyroid disorder case finding during pregnancy, and the development of Polish trimester-specific reference values of thyroid hormones. Comprehensive Polish guidelines developed by the Task Force are to systematize the management of the thyroid disorders in pregnant women in Poland.
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