Гинекология и акушерство

Гинекология и акушерство
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ISSN: 2161-0932


Thyroid Disease Screening for All Pregnant Women as a Universal Accepted Consensus Guideline: A Short Review

Xiao Jing Dong

Till date, the debate on whether to screen pregnant women presented on their first visit to the clinic for antenatal has not come to a decisive conclusion. This paper reviewed the recommendation by the American Thyroid Association (ATA) and Endocrine Society Guideline (ESG), which does not recommend screening for thyroid dysfunction for all pregnant women. According to ATA, there is insufficient evidence to recommend for or against universal screening for abnormal TSH concentrations preconception, except for women planning assisted reproduction or those known to have TPOAb positivity. This review includes studies and publications from a Randomized trial, meta-analyses, retrospective studies, and peer reviews pointing out few physiological changes which predispose women to thyroid dysfunction and other risk factors which are acquired and play a significant role in thyroid malfunction, making thyroid disease common among pregnant women. Basing our decision to test for thyroid dysfunction among pregnant women on clinical judgment on their prenatal visit may not be the best approach as most pregnant women in need of the medical intervention of thyroid dysfunction will likely be unidentified. This could be due to clinical features of the disease being masked by the physiological changes that accompany pregnancy. The effect of thyroid dysfunction on pregnancy outcome is no longer a thing of debate, but taking appropriate measures towards avoiding the occurrence of such devastating effect has been a bone of contention among physicians, obstetricians, gynaecologist and various medical bodies. There is need for thyroid screening with evidence from various studies, having met the criteria for any disease to be considered for screening.