Patton Phillip E, Samuels Mary H, Trinidad Rosen, Caughey Aaron B
Professor of Obstetrics & Gynecology, Division of Reproductive Endocrinology & Infertility, Oregon Health & Science University, Portland, OR.
Professor of Medicine, Division of Endocrinology, Diabetes and Clinical Nutrition, Oregon Health & Science University, Portland, OR.
Obstet Gynecol Surv. 2014 Jun;69(6):346-58. doi: 10.1097/OGX.0000000000000075.
In the last 3 years, we have witnessed the publication of multiple but conflicting guidelines on the management of hypothyroidism during pregnancy. Hypothyroidism is one of the most common endocrinopathies in reproductive-age and pregnant women. Given the prevalence of thyroid disease, it is highly likely that obstetricians will encounter and provide care for pregnant women with thyroid disease. Therefore, a review of current guidelines and management options is clinically relevant.
Our goals are to review the changes in thyroid function during pregnancy, the options for testing for thyroid disease, the different categories of thyroid dysfunction and surveillance strategies among subspecialty societies, and the obstetric hazards associated with thyroid dysfunction and review the evidence for benefit of treatment options for thyroid disease.
We reviewed key subspecialty guidelines, as well as current and ongoing studies focused on the treatment of hypothyroidism during pregnancy.
There are significant differences in the identification and management of thyroid disease during pregnancy among subspecialists. We present our recommendations based on the available evidence.
Evidence exists that obstetricians struggle with the diagnosis and treatment of hypothyroidism. According to recent surveys, the management of hypothyroidism during pregnancy is the number 1 endocrine topic of interest for obstetricians. A synopsis of recently published subspecialty guidelines is timely.
Recent, evidence-based findings indicate that obstetricians should consider modifying their approach to the identification and treatment of thyroid disease during pregnancy.
在过去3年里，我们目睹了关于孕期甲状腺功能减退管理的多项相互冲突的指南的发布。甲状腺功能减退是育龄期和孕妇中最常见的内分泌疾病之一。鉴于甲状腺疾病的患病率，产科医生很有可能会遇到患有甲状腺疾病的孕妇并为其提供护理。因此，对当前指南和管理方案进行综述具有临床相关性。
我们的目标是综述孕期甲状腺功能的变化、甲状腺疾病的检测方法、甲状腺功能障碍的不同类别以及各专科协会的监测策略，以及与甲状腺功能障碍相关的产科风险，并综述甲状腺疾病治疗方案获益的证据。
我们综述了关键专科指南以及目前正在进行的关于孕期甲状腺功能减退治疗的研究。
各专科医生在孕期甲状腺疾病的识别和管理方面存在显著差异。我们根据现有证据提出建议。
有证据表明产科医生在甲状腺功能减退的诊断和治疗方面存在困难。根据最近的调查，孕期甲状腺功能减退的管理是产科医生最感兴趣的内分泌话题。及时总结最近发布的专科指南很有必要。
最近基于证据的研究结果表明，产科医生应考虑改变他们在孕期识别和治疗甲状腺疾病的方法。
