Clinical practice guideline: Management of thyroid dysfunction during pregnancy and postpartum: An endocrine society clinical practice guideline

摘要: Objective: The objective is to provide clinical guidelines for the management of thyroid problems present during pregnancy and in postpartum. Participants: Chair was selected by Clinical Guidelines Subcommittee (CGS) Endocrine Society. requested participation Latin American Thyroid Society, Asia Oceania Association, European Association Endocrinologists, each organization appointed a member task force. Two members Society were also asked participate. group worked on 2 yr held two meetings. There no corporate funding, received remuneration. Evidence: Applicable published peer-reviewed literature last decades reviewed, with concentration original investigations. grading evidence done using United States Preventive Services Task Force system and, where possible, GRADE system. Consensus Process: achieved through conference calls, meetings, exchange many drafts E-mail. manuscript reviewed concurrently Society’s CGS, Affairs Committee, collaborating societies. Many valuable suggestions incorporated into final document. Each societies endorsed guidelines. Conclusions: Management diseases requires special considerations because induces major changes function, maternal disease can have adverse effects fetus. Care coordination among several healthcare professionals. Avoiding (and fetal) hypothyroidism importance potential damage fetal neural development, an increased incidence miscarriage, preterm delivery. Maternal hyperthyroidism its treatment may be accompanied coincident function. Autoimmune associated both rates which appropriate medical response uncertain at this time, postpartum thyroiditis. Fine-needle aspiration cytology should performed dominant nodules discovered pregnancy. Radioactive isotopes must avoided lactation. Universal screening pregnant women not yet supported adequate studies, but case finding targeted specific groups patients who are risk strongly supported. (J Clin Endocrinol Metab 92: S1–S47, 2007)