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Guidelines To Manage Thyroid During Pregnancy

The  guidelines for the management of thyroid disease during pregnancy and after birth has been recently updated from its earlier version. The clinical practice guideline, published in the Journal of Clinical Endocrinology and Metabolism, recommend approaches to diagnosing and treating patients with thyroid-related medical issues before, during, and immediately after pregnancy.

Thyroid function tests change during pregnancy due to the influence of two main hormones: human chorionic gonadotropin (hCG), the hormone that is measured in the pregnancy test and estrogen, the main female hormone. For the first 10-12 weeks of pregnancy, the baby is completely dependent on the mother for the production of thyroid hormone. By the end of the first trimester, the baby’s thyroid begins to produce thyroid hormone on its own. The baby, however, remains dependent on the mother for ingestion of adequate amounts of iodine, which is essential to make the thyroid hormones.

The new clinical guidelines include:

The committee could not reach a consensus on screening recommendations for all newly pregnant women. Some members recommended screening of all pregnant women for serum TSH abnormalities by the ninth week or at the time of their first visit.


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