Ambulantná terapia 4/2008

THYROIDAL DYSFUNCTION IN PREGNANCY – CONSEQUENCES, RECOGNITION AND THERAPY

It is well known that hyperthyroidism or hypothyroidism in pregnancy, if left untreated, influence unfavorably both course of the pregnancy and the development of fetus. However, subtle forms of hypothyroidism (e. g., mild increased thyreotropinaemia, isolated hypothyroxinaemia) in the first trimester are also important risk factors for course of pregnancy, fetal (especially psychoneural) development, neonatal morbidity and postnatal child mental development (IQ). These conditions are of particular frequency in women of child-bearing age with autoimmune diffuse lymphoid thyroiditis and are well preventable by early thyroxine treatment from the first trimester. Early recognition and treatment, and close surveillance by endocrinologist of all these pregnancies by endocrinologist requires mutual cooperation with primary care physician and obstetrician.

Keywords: pregnancy, hyperthyroidism, hypothyroidism, thyroiditis, psychoneural development, screening, therapy