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Management of overt hypothyroidism during pregnancy.
Best Pract Res Clin Endocrinol Metab. 2020 Jun 18 [Online ahead of print]BP

Abstract

Overt hypothyroidism is a common endocrine disorder affecting 1-2% of women of reproductive age. Optimizing treatment in pregnant women with overt hypothyroidism can reduce adverse fetal and maternal outcomes. Ideally, women who are known to have a history of hypothyroidism or those with risk factors for becoming hypothyroid, should have adequate preconception care to ensure euthyroidism from the onset of pregnancy, with a TSH target of below 2.5mIU/L. On women who are already on levothyroxine, an empirical dose increase of 30-50% as soon as pregnancy is confirmed may be considered. During pregnancy, levothyroxine doses should be titrated against TSH, which have trimester-specific ranges. In women who are known to be hypothyroid but are inadequately treated, we recommend a doubling of levothyroxine dose on at least three days a week to rapidly achieve euthyroidism. In newly diagnosed overt hypothyroidism in pregnancy, starting doses of either 100 or 150 mg daily may be considered safe.

Authors+Show Affiliations

Department of Obstetrics and Gynaecology, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074.Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228. Electronic address: obgchan@nus.edu.sg.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32616466

Citation

Li, Sarah Weiling, and Shiao-Yng Chan. "Management of Overt Hypothyroidism During Pregnancy." Best Practice & Research. Clinical Endocrinology & Metabolism, 2020, p. 101439.
Li SW, Chan SY. Management of overt hypothyroidism during pregnancy. Best Pract Res Clin Endocrinol Metab. 2020.
Li, S. W., & Chan, S. Y. (2020). Management of overt hypothyroidism during pregnancy. Best Practice & Research. Clinical Endocrinology & Metabolism, 101439. https://doi.org/10.1016/j.beem.2020.101439
Li SW, Chan SY. Management of Overt Hypothyroidism During Pregnancy. Best Pract Res Clin Endocrinol Metab. 2020 Jun 18;101439. PubMed PMID: 32616466.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management of overt hypothyroidism during pregnancy. AU - Li,Sarah Weiling, AU - Chan,Shiao-Yng, Y1 - 2020/06/18/ PY - 2020/7/4/entrez KW - TSH KW - empirical dose increase KW - euthyroidism KW - levothyroxine KW - overt hypothyroidism KW - trimester-specific ranges SP - 101439 EP - 101439 JF - Best practice & research. Clinical endocrinology & metabolism JO - Best Pract. Res. Clin. Endocrinol. Metab. N2 - Overt hypothyroidism is a common endocrine disorder affecting 1-2% of women of reproductive age. Optimizing treatment in pregnant women with overt hypothyroidism can reduce adverse fetal and maternal outcomes. Ideally, women who are known to have a history of hypothyroidism or those with risk factors for becoming hypothyroid, should have adequate preconception care to ensure euthyroidism from the onset of pregnancy, with a TSH target of below 2.5mIU/L. On women who are already on levothyroxine, an empirical dose increase of 30-50% as soon as pregnancy is confirmed may be considered. During pregnancy, levothyroxine doses should be titrated against TSH, which have trimester-specific ranges. In women who are known to be hypothyroid but are inadequately treated, we recommend a doubling of levothyroxine dose on at least three days a week to rapidly achieve euthyroidism. In newly diagnosed overt hypothyroidism in pregnancy, starting doses of either 100 or 150 mg daily may be considered safe. SN - 1878-1594 UR - https://www.unboundmedicine.com/medline/citation/32616466/Management_of_overt_hypothyroidism_during_pregnancy L2 - https://linkinghub.elsevier.com/retrieve/pii/S1521-690X(20)30066-X DB - PRIME DP - Unbound Medicine ER -
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