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Preconceptional Management of Thyroid Disease

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Thyroid Disease in Pregnancy - A Guide to Clinical Management

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Abstract

Thyroid disorders are common in women of childbearing age. Accordingly, women with thyroid dysfunction who are seeking future pregnancy should have preconception counselling to review the status of their thyroid health, emphasizing improving future pregnancy outcomes. It is important to discuss the impact of thyroid dysfunction on pregnancy outcome, influence of pregnancy on thyroid disease, and the safety profile of all available therapeutic options available, including any potential adverse effects on the mother and fetus. Preconceptional care aims to optimize thyroid function and educate patients in preparation for conception. This requires a systematic approach that includes rational screening, appropriate management, and pragmatic advice. Targeted TSH screening, levothyroxine treatment of patients with serum TSH >4.0 mU/L to achieve a target TSH <2.5 mU/L in patients with hypothyroidism, and switching from methimazole to propylthiouracil before conception have been recommended.

Authors’ Contributions: KGR has drafted the book chapter. Both authors have edited and approved the final manuscript.

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Authors and Affiliations

  1. Department of Endocrinology, JIPMER, Puducherry, India

    K. G. Rashmi & Jayaprakash Sahoo

Authors
  1. K. G. Rashmi
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  2. Jayaprakash Sahoo
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Editors and Affiliations

  1. Dept. of Obstetrics and Gynaecology, JIPMER, Puducherry, India

    Haritha Sagili

  2. Dept. of Endocrinology, JIPMER, Puducherry, India

    Jayaprakash Sahoo

  3. Dept. of Obstetrics and Gynaecology, Sri Venkateswaraa Medical College Hospital and Research Centre, Puducherry, India

    Swaramya Chandrasekaran

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Rashmi, K.G., Sahoo, J. (2023). Preconceptional Management of Thyroid Disease. In: Sagili, H., Sahoo, J., Chandrasekaran, S. (eds) Thyroid Disease in Pregnancy - A Guide to Clinical Management. Springer, Singapore. https://doi.org/10.1007/978-981-99-5423-0_2

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  • DOI: https://doi.org/10.1007/978-981-99-5423-0_2

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