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

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.

摘要：

近二十年来, 妊娠期和产后甲状腺功能障碍问题越来越受到内分泌医生和妇产科医生的重视, 妇产科医生往往是第一个诊断孕妇甲状腺功能受损的医生。在此背景下, 已经出版并修订了一系列不同的临床指南, 最新的临床指南以2017年ATA指南为代表, 该指南涉及主题广泛, 其中包括碘补充、甲状腺自身免疫、甲状腺功能亢进和减退、甲状腺结节和癌症、产后管理以及孕前筛查的必要性。这篇综述的目的就是通过关注最新指南中引入的循证医学变化, 来为妇产科读者提供实用的指导, 特别是这两个方面：(a)在患者转诊前行内分泌测试;(b)就一些常见问题提供基于循证医学的答案

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Thyroid
• pregnancy
• guidelines
• screening
• hypothyroidism

Disclosure statement

No conflict of interest has been reported by the authors.