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Thyroid Treatment Guidelines for Pregnant Women Revised
Date:8/14/2012

TUESDAY, Aug. 14 (HealthDay News) -- Thyroid hormone is critical for normal fetal brain development, and hormonal problems among pregnant women must be properly managed, according to the Endocrine Society, which just revised its guidelines on treating thyroid-related medical issues before, during and after pregnancy.

Too much or not enough thyroid hormone can harm both women and their unborn babies, the experts said. The treatment guidelines update the 2007 version.

"Pregnancy may affect the course of thyroid diseases and, conversely, thyroid diseases may affect the course of pregnancy," said lead study author Dr. Leslie de Groot, a research professor at the University of Rhode Island, in a society news release. "Pregnant women may be under the care of multiple health care professionals, including obstetricians, nurse midwives, family practitioners and endocrinologists, making the development of guidelines all the more critical."

Women who are hypothyroid (their thyroid function is underactive) are at greater risk for infertility and are more likely to have anemia, gestational hypertension and postpartum hemorrhage, the news release noted. If not treated, hypothyroidism during pregnancy can lead to premature birth, low birth weight and respiratory distress among newborns. Overactive thyroid function, or hyperthyroidism, also can lead to miscarriage.

The Endocrine Society made the following revisions to its clinical practice guidelines:

  • Doctors should interpret serum-free thyroxine levels cautiously during pregnancy. The experts advised that using trimester-specific reference ranges would improve the interpretation of pregnant women's thyroid-function tests.
  • The drug propylthiouracil (PTU) should be the primary treatment for hyperthyroidism during the first trimester of pregnancy. The experts cautioned the alternate treatment -- methimazole -- may increase the risk for birth defects. Methimazole,
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