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내분비내과/갑상선기능저하증

갑상선기능저하증 위험이 있거나 임신 중인 여성에서 갑상선호르몬 처방

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갑상선기능저하증 위험이 있거나 임신 중인 여성에서 갑상선호르몬 처방*

 

REF. UpToDate 2022.05.23

Refer to UpToDate content on screening for thyroid dysfunction during pregnancy for identification of risk factors for hypothyroidism.

TSH: thyroid-stimulating hormone; TPO: thyroid peroxidase antibodies; T4: thyroxine.

* This algorithm is intended for use in pregnant women who are not currently taking thyroid hormone.

4 mU/L or population and trimester-specific upper limit of normal, if available.

Δ The presence of TPO antibodies guides management during pregnancy. It informs the extent of autoimmunity, the risk of pregnancy loss, and the risk of postpartum thyroid dysfunction.

Free T4 should be interpreted using assay method and trimester-specific reference ranges.

§ For individuals at high risk for developing hypothyroidism (eg, radioiodine treatment, hemithyroidectomy, exposure to high-dose irradiation of the head and neck), monitor TSH at least once more during the first trimester and again mid-pregnancy. Treat with levothyroxine if TSH rises above 4 mU/L.

¥ Suggestion is based upon weak evidence. The approach to management varies. If a decision is made not to treat, measure TSH approximately every 4 weeks during the first trimester, then once in each of the second and third trimesters to monitor for the development of hypothyroidism. Treat with levothyroxine if TSH rises above 4 mU/L.


 

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