2017 ATA guidelines on the management of thyroid dysfunctions in pregnancy: what do OB/GYNs need to know?

Gynecol Endocrinol. 2019 Apr;35(4):276-279. doi: 10.1080/09513590.2018.1532496. Epub 2019 Feb 5.

Abstract

In the past two decades, the issue of thyroid dysfunctions during pregnancy and the postpartum period received increasing attention by both endocrinologists and obstetrics/gynecologists (OB/GYNs), the latter often became the first to diagnose an impaired thyroid function in pregnant women. In this setting, a series of different clinical guidelines have been published and reviewed, the latest ones being represented by the 2017 ATA guidelines, which extensively address a wide variety of topics, including iodine supplementation, thyroid autoimmunity, hyper- and hypo-thyroidism, thyroid nodules and cancer, post-partum management, as well as the need for pre-conception screening. Aim of this editorial is to offer a practical guidance to the OB/GYN reader by focusing upon evidence-based changes introduced by the latest guidelines, with particular regard to: (a) prescribing further endocrine testing before referral; (b) providing evidence-based answers to some of the frequently asked questions.

Keywords: Thyroid; guidelines; hypothyroidism; pregnancy; screening.

MeSH terms

  • Female
  • Humans
  • Iodine / administration & dosage
  • Practice Guidelines as Topic
  • Pregnancy
  • Pregnancy Complications / blood
  • Pregnancy Complications / diagnosis*
  • Pregnancy Complications / therapy
  • Thyroid Diseases / blood
  • Thyroid Diseases / diagnosis*
  • Thyroid Diseases / therapy
  • Thyrotropin / blood
  • Trace Elements / administration & dosage

Substances

  • Trace Elements
  • Thyrotropin
  • Iodine